In 2015, we blogged about the Oncology Medical Home (OMH) Pilot Program kicking off at the Commission on Cancer (CoC). After two years, we thought it would be a great time for an update on what has been going on!
When we first posted about the initiative, the CoC conducted a beta test of the OMH Standards and the Survey process. Ten OMH practices (as opposed to hospital-based cancer centers) were surveyed – all received accreditation in their pilot processes.
The OMH accreditation model’s overarching goal is to ensure that patients receive the right care at the right time and in the right place. As such, the core of the OMH Pilot Program provides a foundation for adapting oncology treatment to coincide with emerging value-based care models.
The OMH model is centered on five key elements for any OMH, with specific goals for each item:
- Patient engagement: “Empower and educate patients to understand their treatments and the side effects, where to go for medical care and financial counseling.”
- Expanded access: “Provide patients with same day (24/7) urgent care on weekdays, weekends, holidays and evenings to avoid emergency department visits.”
- Evidence-based medicine: “Follow standardized evidence-based guidelines consistent with National Comprehensive Cancer Network (NCCN) or American Society for Clinical Oncology (ASCO) protocols, demonstrate safe medication usage and appropriate utilization of laboratory and imaging study resources, and encourage clinical trial enrollment.”
- Team-based care: “Focus on addressing the full scope of patient needs (medical, economic and psychosocial) and developing relationships with external providers and hospitals providing care to the OMH’s patients.”
- Quality improvement: “Continually review and measure the care within the practice and compare performance to other practices. Demonstrate the provision of high-quality care through performance summaries and data submission.”
The Pilot Program focused on providing OMHs with accreditation based upon compliance scores (1 for compliant, 5 for non-compliant and 8 for non-applicable) based on certain standards pertaining to the five areas listed above. You can find the full OMH Standards Manual here.
In more recent developments, the CoC conducted additional pilot surveys in 2016 as part of the OMH accreditation process. This year, Senate Bill S.463 - Cancer Care Payment Reform Act of 2017 is under review by the Senate Finance Committee. The Bill seeks to encourage the use of the Oncology Medical Home model, which will create a National Oncology Medical Home Demonstration Project comparing the costs and effectiveness of different treatments and practices over the next five years. The Bill also will affect how Medicare covers oncology treatment. It places more emphasis upon coordinated treatment programs, furthering the value-based direction of the industry and aiming to cut costs associated with unnecessary emergency department visits.
To recap, an OMH is a healthcare model consisting of a physician-led care team that applies coordinated technology to ensure that patients receive continued, comprehensive care throughout the treatment process. One of the primary goals of this method of care is to keep cancer patients out of the hospital. The complexity of cancer treatment means that there are many opportunities for issues to arise, so proper coordination is absolutely essential to providing the best outcomes for all types of patients, including those being treated via OMHs.
The OMH is an appealing model because it reduces the risk of readmission by ensuring quality care. Readmission is a big risk in oncology because patients in already weakened states are more susceptible to developing comorbidities. Primary care physicians can easily be overwhelmed with the needs of cancer patients, so having the right structures and resources in place to handle any bumps in the road can make all the difference to achieving positive outcomes.We’re excited about the recent OMH developments and are looking forward to seeing the transition to value-based care play out in oncology. Improved coordination, patient engagement and emphasis on the unique needs of cancer patients are likely to be the main drivers of care quality – all of which the CoC’s OMH standards support!