Oct 15, 2015
By Virginia Anderson
ASCO’s newest department has been operating for less than a year, but already it has embarked on consequential projects for the benefit of oncology practitioners around the country. The Clinical Affairs Department is dedicated to providing services, education, and resources to support oncology practices, and to promoting the delivery of high-quality, high-value care for people living with cancer.
To achieve this aim, the department will develop tools and services to facilitate innovation in cancer care delivery and to respond to the growing economic and administrative challenges in oncology practice, particularly in the areas of business analytics, performance improvement, and practice management.
The ASCO Board of Directors originally conceived of such a department three years ago. “We were thinking about the future of ASCO and asking ourselves how we could best serve our members and our patients. It was clear that, within the organization, there were activities in support of practices and patients, but they had never been combined under a cohesive program. We knew it was important for our members to have a department that brings together all of the services they need to practice efficiently and provide high-quality care to their patients,” said Stephen S. Grubbs, MD, who serves as Senior Director of the Clinical Affairs Department.
Dr. Grubbs, three departmental directors, and dedicated staff will serve the full spectrum of membership, assisting physicians in every kind of practice setting. And in keeping with ASCO’s mission, the department’s ultimate consideration will be the well-being of patients with cancer.
“There’s a rule that I applied in my own practice: ‘The right business decision is the one that’s in the best interest of your patients.’ I’ve always followed that rule and it’s always worked,” Dr. Grubbs said.
He brings 31 years of community practice experience to inform the direction of the Clinical Affairs Department. Before joining the department on a full-time basis in July 2015, he was managing partner at Medical Oncology Hematology Consultants, PA, in Delaware, and Principal Investigator of the Delaware Christiana Care National Cancer Institute Community Oncology Research Program.
In addition, he is well acquainted with ASCO through his service in numerous volunteer positions, including the Board of Directors and the Finance, Ethics, Cancer Research, and Government Relations Committees. He has been a member of ASCO since 1985.
As a cross-functional department, which will work closely with ASCO’s Cancer Policy Department, Institute for Quality, Clinical Practice Committee, Government Relations Committee, and other groups, “we’ll bring all of ASCO’s resources together to streamline access for practices and get them the right information when they need it. As a career-long member of ASCO, I know how valuable these resources are, and I want all of our members to know what we offer to support them,” Dr. Grubbs said.
To that end, the Clinical Affairs Department has kicked off its first year with two major endeavors that will directly affect the operation of oncology practices in the United States: PracticeNET, a business-based rapid learning system, and the Patient-Centered Oncology Payment: Payment Reform to Support Higher Quality, More Affordable Cancer Care payment structure proposal.
“I know from personal experience that a lot of our members and their practices are worried about the future,” Dr. Grubbs said. The Clinical Affairs Department “is going to have the tools to help them be successful.”
PracticeNET: Harnessing big data for practice improvement
ASCO’s rapid learning system for oncology business measurement, PracticeNET (Networking for Education and Transformation), is a network in which practices can share and receive insights to enhance their business operations and quality of care.
Practices can sign up online to participate. At least one physician at the practice must be an active member of ASCO.
Participating practices submit business, operational, administrative, and quality data on a monthly basis through a simple, streamlined collection system. All submitted data is confidential and de-identified. In return, participating practices receive:
- Quarterly reports measuring their practice and individual physicians against a national database of similar practices
- An annual “state of your practice” assessment on key production and cost measurements
- Networking opportunities for business knowledge, benchmarking, and best practices
- Continuous collaboration for spontaneous skill advancement
Since its launch in May 2015, PracticeNET has received data from several practices, with the goal of expanding to include 200 practices over the next year. This large data pool will enable practices to learn from each other and make their businesses more efficient while maintaining high standards of patient care—no matter the practice setting or size, Dr. Grubbs said.
Two leaders in oncology business measurement and practice improvement are the driving force behind PracticeNET, bringing a wealth of experience to the Clinical Affairs Department. Elaine L. Towle, CMPE, ASCO Director of Analysis and Consulting Services, was previously Director of Consulting Services for Oncology Metrics, where she developed programs and services focused on clinical, financial, and operational excellence for community oncology providers. Thomas R. Barr, MBA, ASCO Director of Business Metrics and Analysis, is a founder of the Oncology Circle, a benchmarking and networking collaborative of oncology practices throughout the United States (an organization with which Ms. Towle has also worked). Mr. Barr is the originator of the National Practice Benchmark in Oncology, the authoritative source of benchmarks in oncology, and is the principal author of Trends from the National Practice Benchmark, published annually in the Journal of Oncology Practice.
Payment reform: A new system for a changing landscape
“Oncology practices are operating in a dramatically changing health care system—I think we all know this—and reimbursement is going to change significantly over the next three to five years,” Dr. Grubbs said. “Our focus is on helping practices work through the maze of changes so that they can maintain their high level of service to their patients.”
ASCO is working to get out in front of federally mandated reimbursement changes with its Patient-Centered Oncology Payment: Payment Reform to Support Higher Quality, More Affordable Cancer Care (PCOP) proposal, developed by Society leadership and expert volunteers.
PCOP would fundamentally restructure the way oncologists are paid for cancer care in the United States by providing sufficient payment to support the full range of services that patients need and removing the barriers created by the current payment system to delivering high-quality, affordable care. It would simultaneously improve services to patients and reduce spending for Medicare and other payers. Furthermore, it would enable oncology practices to take greater accountability for key aspects of cancer-care spending without harming patients and without putting practices at risk for costs they cannot control.
The proposed structure meets the definition of an Alternative Payment Model as set out in legislation that the U.S. Congress enacted in April 2015 to repeal Medicare’s Sustainable Growth Rate formula. This legislation encourages the development of alternatives to the current Medicare fee-for-service payment system as a strategy to achieve higher quality, more affordable care.
Under PCOP, oncology practices would commit to delivering evidence-based care, ensuring patients receive the most appropriate tests and treatments while avoiding unnecessary expenses. ASCO has estimated that, under PCOP, oncology practices would receive a significant increase in payments for patient services compared to what they receive today, yet overall spending on cancer care would decrease because patients would avoid expensive hospitalizations and unnecessary tests and treatments.
The Clinical Affairs Department “has the ability to collect data from a practice and its payer and then model that data to see if the program will work from all sides: high-quality care for the patient, value for the payer, and a sustainable business model for the practice,” Dr. Grubbs said.
The Society’s payment reform efforts are led by Walter E. Birch, ASCO Director of Practice Management, who has previously served as Administrative Director of FirstHealth Richmond Medical Group and Executive Director of the Urology Center of Florida, among other positions.
Thinking ahead: Long-term plans for the Clinical Affairs Department
As the Clinical Affairs Department works to have a significant effect on key practice issues in the United States over the next one to two years, Dr. Grubbs and staff are thinking ahead toward future goals and long-term support for oncology practices. Here, Dr. Grubbs highlights just a few of the programs that the department plans to develop over the next several years.
Integrated big-data initiatives: “As the practice environment becomes increasingly data-driven, we hope to see PracticeNET integrated into CancerLinQ™, ASCO’s rapid learning system for cancer care, and have the participation of every oncology practice. We’ll use the data collected to offer tools to practices that will help them offer sustainable, high-quality care—products that can be modified to support every kind of practice to help them achieve their goals.”
Enhancing the value of Quality Oncology Practice Initiative (QOPI®) Certification: “It’s too early to say exactly where it will go, but we’re looking at some new ideas that may offer a financial benefit to practices that have achieved QOPI Certification.”
Support for practices around the world: “As we confirm the success of programs and get our house in order in the United States, we’ll absolutely be working in a global direction, making business lessons learned here applicable to practices in other countries. International colleagues, be assured that you are on our minds.”