A panel at the 2022 Community Oncology Alliance (COA) Conference discussed the building and implementation of the American Society of Clinical Oncology (ASCO) and COA Oncology Medical Home Model, touching on its quality, outcomes, and value in cancer care. 

Bo Gamble, Director of Quality & Value, COA, Moderator, noted that oncology payment reform models consist of three parts: care delivery, payment methodology, and performance/quality measures. In September of 2020, Mr Gamble’s team at COA counted 35 different oncology payment reform models in the US. “The sad part is, in all these models, all three components were different,” Mr Gamble said, adding that these inconsistencies came as a result of payers’ influence over the construction of these models. He believes that insurance companies should not be influencing what “quality care” means. 

The ASCO patient-centered cancer care certification pilot featuring ASCO and COA Oncology Medical Home aims to improve access to care, care coordination, and overall quality, and create a standardized view. 

Stephen Grubbs, MD, FASCO , Vice President, Care Delivery, American Society of Clinical Oncology, discussed “ASCO-COA Oncology Medical Home Standards,” a program that ASCO and COA are piloting. This program includes 7 domains, 18 standards, and 22 additional standards with Chemotherapy Safety domain. “What we’re trying to do in this program to get certification is to have a balanced measure scorecard,” said Dr Grubbs. Patient feedback, evidence based medicine, quality cancer care, and resource utilization and cost were included in the Balanced Measurement Scorecard for this program. The pilot started on July 1,2021, and certification for this pilot is expected in May 2022.

Ronda Bowman, MHA, RN, OCN, Director, Patient-Centered Cancer Care, ASCO, explained what it was like to see this program on the practice level. The ASCO Patient-Centered Cancer Care Certification Pilot included 12 practices, 88 sites of service, and 482 oncologists. Ms Bowman said that it was important to include a variation in practice type and size in this pilot, which ensured that the standards are applicable to all types and sizes of practices. 

“A single set of standards from ASCO and COA provide the blueprint and the direction and the path forward for the practice,” Ms Bowman said, adding that there’s been a lot of appreciative feedback from the participating practices. Ms Bowman reported that a physician leader from one of the participating practices said that this single set of standards has aligned his team at the ‘hubsight’ and the community site, providing a common language and goal for the patient, as well as predictability in providing quality and value in cancer care.

Matthew Skelton, MD, Medical Oncologist, Blue Ridge Cancer Care, said that the ASCO and COA Care Model brought positive change in terms of quality in cancer care at Blue Ridge. He said that value-based care not only prioritizes the efficacy, safety, and cost of therapy in cancer care. He noted that scorecards have helped dramatically, as they’ve been “a powerful motivator.”

Natalie Dickson, MD, MMHC, FACP, President, Chief Strategy Officer, Tennessee Oncology, said that the requirements from ASCO and COA Oncology Medical Home Pilot seemed like a natural extension of the focus at Tennessee Oncology, and the certification allowed the opportunity to be acknowledged for their work. Dr Dickson said that the care model raised an awareness that there is more work to do to reach health equity at Tennessee Oncology. She said the technical aspect of transmitting data has presented a significant challenge for the practice because Tennessee Oncology is not part of a CancerLinq network, ASCO’s mechanism to receive practice’s data, therefore, they’re forced to manually submit their data. 

Dr Grubbs discussed the next steps of the pilot, which includes improvements in data collection, and said that this pilot will run through June 2023, and is expected to become a program available to multiple practices in the US.