ASCO Launches Oncology Medical Home Model

Roxanne Nelson, BSN, RN

November 17, 2016

A new initiative launched by the American Society of Clinical Oncology (ASCO) aims to help community oncology practices move away from volume-based towards value-based care by structuring reimbursement around the full range of services needed by patients with cancer.

It will also prepare oncology practices for full implementation of the Quality Payment Program, authorized by the Medicare Access and CHIP Reauthorization Act (MACRA) and will be available across the United States starting on January 1, 2017.

The initiative has been developed in collaboration with Innovative Oncology Business Solutions Inc (IOBS), which pioneered the model under its Community Oncology Medical Home (COME HOME) program.

That program began in 2012, when the Center for Medicare & Medicaid Innovation awarded a 3-year grant for a pilot program, which was developed by Barbara L. McAneny, MD, CEO and medical director of IOBS and also managing partner and CEO of the New Mexico Cancer Center, Albuquerque. This pilot COME HOME program implemented specialty medical homes in seven oncology practices across the country.

The goal of the program was to improve health outcomes, enhance patient care experiences, and significantly reduce the cost of care. COME HOME uses a standardized, computer-based decision support tool for first responders and triage nurses, and the program enables patients to receive care in a timely fashion and in a familiar place by offering extended hours, including those on weekends.

ASCO has licensed the COME HOME name from IOBS, along with the model's readiness assessment and implementation tools, and the plan is to replicate and expand the COME HOME program across the United States.

Early Results Promising

The next step is for the participating practices to compare their quality and cost of care, with practices serving as controls and hospital-based systems in their respective regions.

But according to ASCO, the COME HOME practices have already shown that the model is effective in improving health outcomes, enhancing patient care experiences, and "positioning practices for success in an evolving healthcare delivery environment."

Early results from the pilot program show that the rate of 30-day hospital readmissions have dropped by 11.7%, emergency department visits are down by 6.6%, inpatient hospital admissions have declined by 12.5%, and the overall cost of care has been reduced by 7.2%.

All seven practices have also maintained a high patient satisfaction rate, averaging rates of 91.3% to 98.1%, throughout the entire COME HOME Program grant period.

The New ASCO Model

"ASCO has developed, and continues to cultivate, a wide range of resources and tools to guide practicing oncologists through the evolving healthcare delivery landscape," commented Stephen S. Grubbs, MD, ASCO's vice president of clinical affairs.

"What makes ASCO COME HOME particularly exciting is that the program is designed to ultimately provide direct support to help practices establish comprehensive and coordinated oncology care in the new value-based health delivery environment under MACRA and the Quality Payment Program," Dr Grubbs told Medscape Medical News.

"Initial COME HOME practices have shown the model's effectiveness at improving health outcomes, enhancing patient care experiences, and positioning practices for success as the healthcare delivery system evolves," he added. "ASCO looks forward to helping more practices successfully transition from the fee-for-service model to providing value-based cancer care."

The initiative is coming at a time when oncology practices are beginning to implement MACRA-related changes. Like the original COME HOME project, it is designed to help practices establish comprehensive and coordinated oncology care.

The program builds on the efforts that ASCO has developed over the years in order to implement alternative payment systems that support high-quality, patient-centered, value-based cancer care. Last year ASCO released its Patient-Centered Oncology Payment model, which is similar to the COME HOME approach as it is designed to enable all oncology practices to deliver higher-quality care at lower cost.

"Exciting News"

"ASCO has never really embraced the oncology medical home and so this is exciting news that they are getting involved," commented Ted Okon, MBA, executive director of the Community Oncology Alliance. "It will be great for practices to use these services."

"ASCO has developed many initiatives and now they have turned to the oncology medical home model and this one really works," Okon said. "It has been proven to work."

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