Optimizing Cancer Care Delivery in 2022, Part 1

This blog is the first in a two-part series on value-based care transformation.

On March 4, 2022, ACCC President David R. Penberthy, MD, MBA, medical director of radiation oncology at Bon Secours Southside Medical Center in Petersburg, Va., announced his 2022-2023 President’s Theme: "Leveraging Technology to Transform Cancer Care Delivery and the Patient Experience.” Work will focus on the equitable use of data and digital health tools to reduce disparities in care, as well as technology-based strategies to mitigate oncology workforce shortages and improve efficiencies in care delivery.

This theme was woven throughout the April 6 ACCC workshop, “Remaining Focused on Value-Based Care Transformation,” one of many resources under the Association’s Alternative Payment Model Coalition, which seeks to help cancer programs and practices continue their journey toward value-based cancer care delivery. With the Oncology Care Model (OCM) ending in June and no replacement program in sight, cancer programs and practices are looking to alternative care settings—including patients’ homes—and diversified service offerings to strengthen their bottom line.

Re-Evaluating Sites of Care

When the OCM ends, so do the MEOS (Monthly Enhanced Oncology Services) payments that many cancer programs and practices use to fund processes and services that support value-based care. Now, leaders will need to develop and implement creative strategies to offset this financial loss. Mount Sinai Health System in New York City looks to optimize its oncology care settings as one key strategy. Mark Liu, MHA, director of Strategic Initiatives at Mount Sinai Health System, talked about the integrated care settings the health system has created, including:

• An oncology-specialized urgent care center. Though separate from the emergency department (ED), it is still an ambulatory setting, so patients with cancer can be referred from their homes or the ED to this more cost-effective site of service.
• Oncology coordinators who manage transitions of care from the inpatient to outpatient setting. These staff have helped reduce overall treatment wait times for oncology patients and improve continuity of care when patients are released from the hospital. This improved care coordination has reduced readmissions and set patients up to successfully continue their care in a less costly setting.
• Community paramedicine program. Mount Sinai is now using paramedics to deliver certain services (e.g., intravenous hydration and evaluations) in patients’ homes, saving patients and the healthcare system money on the higher costs of care that come from the ED or hospital setting.
• Mobility aides. By rethinking how it delivers inpatient care, Mount Sinai is reducing hospital length of stay and generating downstream revenue from other services (e.g., prehabilitation/rehabilitation) by using medical assistants to improve the mobility of patients admitted to the hospital.
• Telehealth. With one report finding that telehealth use has stabilized at 38 times higher than its pre-COVID-19 use, it is clear that telehealth is here to stay. Patients and healthcare providers have gotten comfortable with this type of care delivery. Patients are further interested in adopting technologies that allow them to receive care from home—care that is more convenient for them and more cost-effective for the health system. To achieve widespread and permanent use of telehealth, Mount Sinai staff are addressing social determinants of health that limit access for certain patient populations and have established a stable reimbursement methodology.
• Remote patient monitoring technology allows for assessment and management of cancer-related complications outside the health system, reducing the number of patient visits to the cancer program and decreasing ED and hospital admissions. Early identification of patient illnesses like sepsis or anemia while using this technology helps reduce acute care use, including unplanned ED visits and hospitalizations.

You can learn more about Mount Sinai Health System’s strategies for continuing value-based care by registering for and watching the on-demand workshop recording.

Read part two of this blog series here. This resource was made possible through the ACCC Alternative Payment Model Coalition that is supported by Merck & Co, Inc, and Takeda Oncology.