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Innovative Cancer Care Initiative #1: Community Oncology Medical Home (COME HOME) Dr. Barbara McAneny Laura Stevens Barry Russo. Disclosure Information. Barbara McAneny , M.D. Employment or Leadership Position: Innovative Oncology Bus. Sol., CEO, Owner Laura Stevens
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Community Oncology Medical Home (COME HOME)
Dr. Barbara McAneny
Barbara McAneny, M.D.
Employment or Leadership Position: Innovative Oncology Bus. Sol., CEO, Owner
Employment or Leadership Position: Innovative Oncology Business Solutions, Program Director/CIO
Stock Ownership: Innovative Oncology Business Solutions
Please note, all disclosures are reported as submitted to the Cancer Center Business Summit and are available at cancerbusinesssummit.com.
Barbara McAneny MD CEO
The project described was supported by Funding Opportunity Number
CMS-1C1-12-0001 from Centers for Medicare and Medicaid Services,
Center for Medicare and Medicaid Innovation. The contents are solely the
responsibility of the authors and have not been approved by the
Department of Health and Human Services, Centers for Medicare & Medicaid Services.
A detailed analysis of the demonstration is currently available only for the first two years. That analysis showed that, for patients in the 10 group practices during the second year, average Medicare spending excluding the bonuses paid to physician groups was about 1 percent below projections; with bonuses included, average Medicare spending was just 0.1 percent below projections—about $7 per beneficiary.
When patients visit a physician office that is part of a hospital’s outpatient department, Medicare pays a facility fee to the hospital and a reduced fee for the physician’s services. The combined fees paid for visits to hospital-based practices are often more than 50 percent greater than rates paid to freestanding practices.
Focus on the patients with expensive illnesses
What factors can doctors control?
What data do we need to prevent complications?
Northwest Georgia Oncology Centers
1. Electronic Health Records – to share/track real-time patient information; monitor quality
2. Best Practices Care: Triage, Diagnostic & Therapeutic Pathways
3. Team-Based Care: Med/Rad Onc, Diag Radiology, NPs, RNs, LPNs, Pharmacists, Med Techs, Care Coordinators, first responders – working as team to keep patients in OP setting and out of ER and hospital. Includes active disease management, patient education and on or near-site lab, imaging and pharmacy.
4. Enhanced Access: 24/7 Triage Line with “first responders”. Extended weekday and weekend hours, same day appointments, and automated pathway follow-up reminders for triage nurses
5. Financial Support for Medical Home Services
Large amount of staff education prior to roll out of the infrastructure changes
Implementation Task Force established
Rolled out requests for existing staff to volunteer to help
Physician Extenders developed their own schedule to support most of the coverage needs
Centralized the phone systems to assist the triage process
Implemented the Case Management focused triage process – “don’t we already do that?”
By Cancer Type
By Cancer Type
Direct admissions (no ED) $196,200
Clinic instead of ED visits $1,208,700
Hospice instead of Hospital $3,900,000
Lower ALOS $2,125,000
Avoided Admissions $18,500,040
*Cost Projections based on Medical Expenditure Panel Survey (MEPS) data for Medicare beneficiaries in ‘poor health’, inflated to reflect higher expenditures associated with cancer.