COA: Community Oncology Alliance

The first day of the 2019 Community Oncology Conference, the major annual meeting of the Community Oncology Alliance (COA), featured an update on its effort to find alternatives to CMS' Oncology Care Model.

To speak about the success and continued development of Priority Health's payment reform model in cancer care, John Fox, MD, medical director at Priority Health, joined Dennis Zoet, chief business development officer at Cancer and Hematology Centers of Western Michigan, on a panel at the Community Oncology Alliance Payer Exchange Summit.

I’ve seen one case recently where a patient received $172,000 of drugs that were totally wasted. So, we’re going to be looking at this, we’re going to be looking at these middlemen getting in the way of the patient and the physician making a decision about their therapy, explained Ted Okon, executive director of COA.

Looking at total cost of care is difficult and figuring out what the practice is responsible for and not responsible for can be very difficult to do, said Lalan Wilfong, MD, executive vice president of Quality Programs at Texas Oncology.

A patient has their own set of values, providers have their own set of values, and the people that pay for it have their own set of values. So, [we all need to] come together, explains Bo Gamble, Director Of Strategic Practice Initiatives at the Community Oncology Alliance.

At the Community Oncology Alliance Payer Exchange Summit, healthcare policy experts from a government relations firm and from the pharmaceutical industry provided an update on the progress with value-based agreements and also discussed the challenges posed by the existing infrastructure and operational framework.

I’m not quite certain that the system is equipped to provide a comfort level for clinicians that they’re ready to take on two-sided risk, explained Lyn Fitzgerald, senior vice president, US & Global Development at the National Comprehensive Cancer Network (NCCN).

We've noticed that all of these transformation activities– care transformation, quality improvement, are all actually working, explained Kavita Patel, MD, MS, non-resident senior fellow at the Brookings Institution.

"The cost of cancer care is rising dramatically," said Lalan Wilfong, MD, executive vice president of quality programs at Texas Oncology.

The Community Oncology Alliance (COA) has been working with its member practices and some payer partners who have successfully implemented innovative care delivery and payment models to develop a 2.0 version of CMS’ Oncology Care Model (OCM). A progress report was presented at COA’s Payer Exchange Summit held October 29-30 in Tyson’s Corner, Virginia.

While practice transformation is vital, community-based clinics continue to struggle with emergency department (ED) use, hospitalization, and risk stratification as they identify ways to reduce unnecessary expenditures within their Oncology Care Model (OCM) practice.

Healthcare is experiencing something fundamentally different with nontraditional mergers across industries, explained Ted Okon, executive director of COA, at the 2018 Community Oncology Conference.

There are 3 legislative priorities for the Community Oncology Alliance (COA) that keep the focus on the patient and ensure better care, explained Ted Okon, executive director of COA, at the 2018 Community Oncology Conference.

Ray Page, DO, PhD, president and director of research at The Center for Cancer and Blood Disorders and chair-elect of the American Society of Clinical Oncology’s (ASCO) Clinical Practice Committee discusses the first results of the Oncology Care Model (OCM) and ASCO’s top legislative priorities.

With chimeric antigen receptor (CAR) T-cell therapy being so new, there is going to be a learning curve as providers become more educated about the treatments, the manufacturing process, and the toxicities, Houston Holmes, MD, MBA, FACP, a medical oncologist with Texas Oncology, explained at the Community Oncology Alliance’s (COA) 2018 Community Oncology Conference.

How are large employers adapting to, and benefiting from, the value-based care practices that are a payer demand and a provider imperative? This was the focus of a panel moderated by Bo Gamble, director of Strategic Practice Initiatives, Community Oncology Alliance (COA), during the 2018 Community Oncology Conference hosted by COA, April 12-13 in National Harbor, Maryland.

A panel of providers discussed key advocacy issues that affect patients and practices and could improve access to care and costs during the 2018 Community Oncology Conference, hosted by the Community Oncology Alliance, April 12-13 in National Harbor, Maryland.

Ray Page, DO, PhD, president and director of research at The Center for Cancer and Blood Disorders and chair-elect of the American Society of Clinical Oncology’s (ASCO) Clinical Practice Committee, provides a look at legislation to improve patient access to treatments and address drug pricing in cancer care.

There is currently a lack of transparency with pharmacy benefit managers around drug prices and where the rebates for drugs are going, but Congress is pushing for greater transparency that will benefit patients, said Ted Okon, executive director of the Community Oncology Alliance.

How are community practices coping with administering chimeric antigen receptor (CAR)-T treatments? At the 2018 Community Oncology Conference hosted by the Community Oncology Alliance, Houston Holmes, MD, MBA, FACP, Texas Oncology, shared his experience with administering CAR T-cells in a community cancer center–based setting.

The Merit-based Incentive Payment System (MIPS) is a big program designed to be applied to all clinicians, which makes it complex to figure out how to do right, explained Richard Kane, senior director at Avalere.

Typically, cancer pain management is carved out of policies that try to restrict opioid prescribing in an effort to combat the opioid epidemic, but with more and more patients surviving their cancer, there is some uncertainty regarding who is affected by these policies, explained Bob Twillman, PhD, executive director for the Academy of Integrative Pain Management.

Richard Kane and Caroline Pearson, both from Avalere Health, provided oncologists gathered at the 2018 Community Oncology Conference an overview of reimbursement programs offered by CMS and advice on navigating them.

At the 2018 Community Oncology Conference hosted by the Community Oncology Alliance, April 12-13 in National Harbor, Maryland, FDA Commissioner Scott Gottlieb, MD, provided the audience with an overview of current and future plans of the regulatory agency, particularly its strides within the molecular diagnostic testing space.

We want to know all sides of the 2-risk model, like with any challenge or strategy, said Roger Brito, DO, national director for oncology, Aetna.

Before undertaking something like implementing the Oncology Care Model, practices should understand the scope of the project and the overall importance it can have for patient care, said Terrill Jordan, CEO of Regional Cancer Care Associates.

When you have constant evolving contract, there are changes, and so some of the feedback I’m getting is that sometimes it’s hard to keep up with the changes, said Peter Aran, MD, medical director of Population Health Management at Blue Cross Blue Shield of Oklahoma.

Providers should be involved in new reimbursement model development from day 1, said Roger Brito, DO, national director for oncology, Aetna.

When a drug becomes first-line, I would like to think that as a clinician I would have access to that, but most importantly that my patients would not have to have a bake sale or take out a second mortgage on their homes to get therapies that are designed specifically for them, said A. Mark Fendrick, MD, director of the Center for Value-Based Insurance Design at the University of Michigan.

Bo Gamble, director of Strategic Practice Initiatives at the Community Oncology Alliance (COA), explains how COA plays a role in supporting practices in preparing for Oncology Care Model.