CORDATA BLOG

Getting Reimbursed for "Care Coordination" Activities

Posted by Cam McClellan Teems

September 4, 2015 at 10:48 AM

Care coordination, navigation and care management have all become quite synonymous thanks to the language around Accountable Care. Each Cordata Oncology client is engaging in different levels of care coordination activities...across various types of oncology programs....some are heavy on the intake or diagnostic phase of a care pathway and others are heavy on the treatment through survivorship phases.

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Topics: reimbursement, billing, Accountable Care, Navigation & Care Coordination

Has Navigation Grown Up to be Care Coordination?

Posted by Cam McClellan Teems

July 28, 2015 at 1:00 PM

Has the traditional term "navigation,” coined by Dr. Freeman in oncology, grown up to now be coined as "care coordination"?  We think so.  Will your internal nomenclature change at your facility or Cancer Center?

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Topics: Accountable Care, Navigation & Care Coordination

All the Buzz About ACOs is Really a Case for Expanded Care Coordination

Posted by Gary Winzenread

June 4, 2015 at 9:57 AM

For the last several years, the Accountable Care Organizations, or ACOs, have been one of the most discussed and debated topics in healthcare.  Nearly every article on the evolution of healthcare or technology advancements refers to ACOs.  Yet, the concept of care coordination is but a whisper in the market today, even though CMS continues to support the concept as a critical aspect of the future of healthcare, recently defining reimbursement paths for the efforts with high risk patients to further support adoption.

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Topics: Accountable Care, Navigation & Care Coordination

Value-Based Cancer Care: It is on the radar yet?

Posted by Cam McClellan Teems

May 15, 2015 at 1:30 PM

The phrase "Value Based Cancer Care" is typically used to mean the entire oncology team is participating in the consideration of the cost-value issues specific to cancer treatments.  Dr. Yu, the leader of the American Society for Clinical Oncology (ASCO) recently said in the ASCO Annual Report, "It is critical that patients and physicians understand the value of treatment options. In any treatment situation, the health and individual needs of the patient are paramount, and determining the value of any particular cancer treatment is a highly personalized process that must be determined between a physician and patient." How do you communicate value to patients at the time of a cancer diagnosis?  Dollars? Life expectancy? Quality of life? Effort of customization? Personalized treatment based on genomic factors?  

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Topics: Cancer Management, Accountable Care

The Evolving Role of the Navigator: The Nordstrom Model at Work Again?

Posted by Cam McClellan Teems

November 7, 2014 at 10:43 AM


Virtually everyone is discussing that now is the time to seriously reexamine our fragmented, expensive healthcare system and to innovate sustainable approaches to curing its ills. Obamacare and the ACA kicked off this discussion again in the last administration - making the consumer the center of the focus. 

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Topics: Accountable Care

Accountable Care for Oncology: Are You Going There?

Posted by Cam McClellan Teems

October 8, 2014 at 2:15 PM

The principal ideas underlying the ACO concept are (1) coordination of care through integrated services (can be virtually integrated); (2) financial incentives for clinicians and hospitals to efficiently manage patients; and (3) an underpinning IT infrastructure for data management and analytics, that supports saving money in the process. And, in the Accountable Care Act’s Medicare Shared Savings initiative, sharing those savings with the provider-partners in the ACO. The majority of ACOs have focused on primary care. The ACO concept is also easily applied to oncology, which may have the highest payoff in terms of cost savings through disease prevention and early diagnosis and management.   Examples of moves toward the oncology ACO model in the United States are:

  • United Healthcare  (5 episode payment pilot sites)
  • Texas Oncology/Innovent Oncology and Aetna
  • Oncology Physician Resource (OPR) and Michigan Blue Cross
  • Wilshire Oncology and Wellpoint, Southern California
  • CareFirst Blue Cross pathways and medical home initiative, Maryland
  • Priority Health oncology medical home initiative, Michigan
  • Florida Blue, Baptist Health South Florida and Advanced Medical Specialties Oncology ACO, Miami
Harvard Pilgrim Health Plan with oncology medical home demonstration pilot, Massachusetts; [i]

[i] The Rapidly Evolving ACO World, Ronald R. Barkley, MS, JD, OBR Green, September 2012 Edition. Vol. 6, Issue 5.

The Oncology ACO is coming and Cordata wants to assist its current and future clients in this evolution and be part of your ACO capable IT infrastructure

If you are interested in becoming an Oncology ACO…let our national oncology leader help make it happen with our oncology application as your ACO capable oncology information technology infrastructure. You can reach her at cam.teems@cordatahealth.com

 

 

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Topics: Accountable Care

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