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Building the Oncology Medical Home

Building the Oncology Medical Home. Panelists. Moderator: Gordon Kuntz , Senior Director, Payer Solutions, ION Solutions Panelists: Susan Tofani , MS , Director Network and Payer Relations, Oncology Management Services, Inc.

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Building the Oncology Medical Home

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  1. Building the Oncology Medical Home

  2. Panelists Moderator:Gordon Kuntz, Senior Director, Payer Solutions, ION SolutionsPanelists:Susan Tofani, MS, Director Network and Payer Relations, Oncology Management Services, Inc. Tracey F. Weisberg, M.D., Medical Oncologist, Maine Center for Cancer Medicine

  3. Building the Oncology Medical Home Tracey F. Weisberg MD Maine Center for Cancer Medicine

  4. Disclosure Information Tracey F. Weisberg, M.D. Employment or Leadership Position: Maine Center for Cancer, President Please note, all disclosures are reported as submitted to the Cancer Center Business Summit and are available at cancerbusinesssummit.com.

  5. MCCM Overview • Private physician-owned practice for over 30 years • Operations in four sites and staff three rural clinics • QOPI certified all four infusion sites • 14 physicians • 13 medical oncologists • 1 internal medicine hospitalist • 3 physicians boarded in palliative care • 8 midlevel providers

  6. MCCM Programs • Contract with Maine Health to deliver education to medical residents, oversee operations of Thoracic Oncology Clinic, Brain Tumor Clinic, Breast Clinic, hospital IV therapy • Hemophilia Clinic • Research Program • Cancer Genetics • Survivorship program • Palliative Care (inpatient and outpatient consultation) • Physician dispensing

  7. MCCM Vision • To provide the highest quality, cost effective cancer care in the region • Optimize cancer treatment outcomes with early integration of pathways, early adoption of new technology and treatment strategies, and continued dedication to cancer research • Patient-centered care

  8. Treatment and Urgent Care Pathways with Data Collection

  9. COME HOME Be present for the patient at the time of their greatest need

  10. Work to the peak of your licensure

  11. Challenges • MCCM for 30 years used a primary nurse model • Physicians enthusiastic, staff skeptical • Staff concern about “having to work more” • NP concern about needing to work extended hours • Lead nurse could not envision change • Phone system revision • Perceived “rigidity” of following an urgent care pathway….”we know how to do this already” • Implementation of urgent care hours • Data collection with new software system

  12. Frustration Leads to Breakthrough…….

  13. We have a new nursing council • Our patients love the extended hours. Families have been grateful not to have ER visits and waits • Physician on-call perhaps a bit lighter • We have new vision about our employee-patient relationship • Hospital wants to use our data to demonstrate that they are working to reduce ER visits etc • Payers interested in new model

  14. Building the Oncology Medical Home Susan H. Tofani Oncology Management Services, Ltd.

  15. Disclosure Information Susan Tofani, MS Employment or Leadership Position: Oncology Management Services, Ltd. Honoraria: ION Solutions Please note, all disclosures are reported as submitted to the Cancer Center Business Summit and are available at cancerbusinesssummit.com.

  16. Building the Oncology Medical HomeTopics to address • Why change… • What is it… • How to get started… • What are the critical components… • Where to look for help…

  17. Why Change… • Preserve and / or enhance revenue • Movement to value-based purchasing (Value = Quality / Cost) • Improve patient experience • Patient – family engagement • Improve operational efficiencies • Overhead costs • Operational costs • Continuous process improvement

  18. Top “10” Lists for 2013 • Top Strategic Priorities for Healthcare Providers (Practices) • Improve patient care/patient satisfaction • Grow practice/find new revenue opportunities • Reduce operational or overhead costs • Increase staff productivity • Implement/improve workflow • Implement/improve an EHR/EMR system •  Improve risk management and compliance • Improve overall technical skill level of staff • Implement/improve new IT equipment • Implement/improve other software systems Top Challenges For Mid-Size Hospitals and Health Systems 1. Physician Alignment/Clinical Integration 2. Cost Control 3. Measuring Outcomes/Operational Efficiencies 4. Census/Patient Volume 5. Reimbursement Reductions 6. EHR/Technology 7. Patient Satisfaction/HCAHPS 8. MD/RN Recruitment 9. Cross-Continuum Partnerships 10. Value-Based Purchasing 11. New Revenue Sources Source: Community Hospital 100 Source: 4th Annual Healthcare IT Insights and Opportunities

  19. Oncology Patient Centered Medical Home® What is it… Model of Oncology Care • Ownership of all aspects of cancer care delivery • Pre-treatment consultation, plan of care • Patient access, engagement & shared decision-making • Treatment coordination & execution • Palliation of symptoms • End of Life Care • Survivorship Care

  20. Outcome MeasuresPatient- & Payer-Centered • Patient Experience • AHRQ CAHPS: Consumer Assessment of Healthcare Providers and Systems • Outcomes • Staging compliance • Chemotherapy guideline adherence • Emergency Room evaluations • Hospital admissions / length of stay • Outpatient visit reduction • End of Life Care parameters • Diagnostics: imaging & laboratory

  21. Resulting inPractice Efficiencies • Reduced staff FTE / physician FTE • Increased patient volume • Engaged staff working at the top of their respective licenses • Fewer physician disruptions • Merger of clinical work flow with technology

  22. How to get started… • “Begin with the end in mind” – Stephen Covey • Select the project team • Physician champion • Research models, evidence-based and best practices • Evaluate your capabilities and capacity • Leadership, decision-making, care-team culture, infrastructure • Determine your approach • Self-study / self-guided • Seminar / workshop • Hands-on assistance

  23. Building a Home

  24. Building a Medical Home

  25. What are the critical components… • Maximize potential of IT systems • Efficient Physician-led care teams • Patient and family engagement • Standardized processes • Coordination and Communication • Performance Measurement and Improvement

  26. Where to look for help…

  27. Where to look for help… • ION Solutions • Practical Guide for Building Value • Oncology Management Services (OMS) • American Society of Clinical Oncology (ASCO) • National Comprehensive Cancer Network (NCCN) • National Coalition on Cancer Survivorship (NCCS) • Community Oncology Alliance (COA) • American College of Physicians (ACP) • National Committee on Quality Assurance (NCQA) Patient Centered Specialty Practice

  28. Thank you Susan Tofani Oncology Management Services stofani@oms-support.com 215-817-7957 www.opcmh.com

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