A federal program to improve quality and affordability for cancer patients while providing more coordinated care called the Oncology Care Model (OCM) was developed by The Center for Medicare & Medicaid (CMMI) Innovation. Oncology/Hematology of Loudoun and Reston through our partnership with the American Oncology Network is one of under 200 practices participating in the OCM, helping our patients eliminate unnecessary costs.
The good news is cancer survival rates are rising. The bad news is the cost of treating cancer is also increasing. In a survey conducted by the American Society of Clinical Oncology in 2018, 60% of respondents indicated they worry about the financial burden of treating their cancer diagnosis.
To participate in the OCM participating practices must provide enhanced patient services including patient access 24 hours a day, 7 days a week with real-time access to the patient’s medical records and treatment with therapies consistent with nationally recognized clinical guidelines. “With the Oncology Care Model, CMS has the opportunity to achieve three goals in the care of this medically complex population who are facing a cancer diagnosis: better care, smarter spending, and healthier people,” said Patrick Conway, M.D., CMS chief medical officer and deputy administrator for innovation and quality. “As a practicing physician and a son of a Medicare beneficiary who died from cancer, I know the importance of well-coordinated care focused on the patients’ needs.”
The overall national spend for cancer in 2018 was $150.8 billion according to the National Cancer Institute. The costs are not just affecting the patients, physicians and clinics are also feeling the pressure as well. The Community Oncology Alliance stated from 2008-2018 that 1,653 clinics were either closed or acquired by a hospital.
Oncology/Hematology of Loudoun and Reston participation in the OCM is helping our community oncology practice provide services that address the complex needs of our cancer patients while providing additional services that specifically improve the patient experience and their overall health outcomes.
All our OCM patients are assigned a dedicated care manager and receive a personalized care plan. The care managers are an extension of our team within the clinics to ensure continuous, high-quality care for our patients in between their office visits. Each patient’s care management team has full access to their medical records and treatment regimen when advising the patient or their support system.
It could be 3 a.m. and a patient may be scared because they’re sick and having side effects. Via phone, the oncology certified nurse can walk them through how to manage that or give their caregivers resources. The nurses are trained to gauge whether the person should go to the hospital or whether it’s not necessary at that point with clear protocols focused on the specific disease. Essentially, the care managers act as a “care coach” to guide patients through their cancer journey.
Care management services reduce unnecessary emergency room visits and unnecessary hospitalizations, especially when those trips aren’t warranted and there are better alternatives. Fewer trips to the hospital can also save some patients thousands of dollars, especially if they face hefty out-of-pocket expenses if they don’t have a supplemental insurance plan.
With more than 16.9 million Americans living with a history of cancer, its imperative to continue to improve upon the systems in place. Oncology/Hematology of Loudoun and Reston is committed to delivering more personalized care at a lower cost to our patients.