Building the Oncology Medical

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PanelistsModerator: Gordon Kuntz, Senior Director, Payer Solutions, ION Solutions

Panelists:Susan Tofani, MS, Director Network and Payer Relations, Oncology Management Services, Inc.

Tracey F. Weisberg, M.D., Medical Oncologist, Maine Center for Cancer Medicine

Building the Oncology Medical Home

Tracey F. Weisberg MDMaine Center for Cancer Medicine

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.

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

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

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

Treatment and Urgent Care Pathways with Data Collection

COME HOME

Be present for the patient at the time of their greatest need

Work to the peak of your licensure

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

Frustration Leads to Breakthrough…….

• 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

Building the Oncology Medical Home

Susan H. TofaniOncology Management Services, Ltd.

Disclosure InformationSusan Tofani, MSEmployment 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.

Not for redistribution. © 2013 Oncology Management Services, Ltd

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…

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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

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Top “10” Lists for 2013Top Challenges For Mid-Size

Hospitals and Health Systems1. Physician Alignment/Clinical Integration2. Cost Control3. Measuring Outcomes/Operational

Efficiencies4. Census/Patient Volume5. Reimbursement Reductions6. EHR/Technology7. Patient Satisfaction/HCAHPS8. MD/RN Recruitment9. Cross-Continuum Partnerships10. Value-Based Purchasing11. New Revenue Sources

Top Strategic Priorities for Healthcare Providers (Practices)

1. Improve patient care/patient satisfaction2. Grow practice/find new revenue

opportunities3. Reduce operational or overhead costs4. Increase staff productivity 5. Implement/improve workflow6. Implement/improve an EHR/EMR system 7. Improve risk management and

compliance 8. Improve overall technical skill level of

staff 9. Implement/improve new IT equipment10. Implement/improve other software

systems Source: 4th Annual Healthcare IT Insights and Opportunities

Source: Community Hospital 100

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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

Not for redistribution. © 2013 Oncology Management Services, Ltd

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

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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

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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

Not for redistribution. © 2013 Oncology Management Services, Ltd

Building a Home

• Streamline• Declutter

Empty Nester

• Remodel/ repurpose• Buy signature pieces• Build an addition• Move

Growing Family• Apartment /First

House• Sparse Furnishings /

Thrift store finds / Empty Rooms

Starting Out

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Building a Medical Home

• Streamline• Continuous

Improvement

Optimization

• Revised roles, reporting and processes

• Add services• Integrate workflow and IT

Growing Pains• Legacy processes• Culture• Economic

Challenges

Starting Out

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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

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Where to look for help…

Building a Home Building a Medical Home

Ideas Stores, magazines, Pinterest, friends, open houses, model homes

Professional groups / meetings, journals, other practices, payers, demonstration projects

Scale Repurpose, remodel, build an addition, or move

Redesign roles and workflow, implement an EMR, add services, standardize policies, enter into payer projects and / or pursue recognition

Approach DIY, buy tools, engage a contractor, hire an architect, move to new house

DIY, attend workshops, buy tools / technology, engage a consultant

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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

Not for redistribution. © 2013 Oncology Management Services, Ltd

Thank you

Susan TofaniOncology Management Servicesstofani@oms-support.com215-817-7957www.opcmh.com