PCLI Meeting Examines Cancer Quality and Oncology Payment Models

More than 85 members of the AACI Physician Clinical Leadership Initiative (PCLI) convened during the AACI/CCAF Annual Meeting, October 15 in Washington, DC. PCLI provides a forum where AACI cancer center clinical services leaders can collect, evaluate, and share best practices that promote the efficient and effective operation of cancer center clinical and quality care programs.

This year’s fifth annual PCLI meeting focused on training programs for advanced practice providers and the role of advanced practice providers (APP) in providing cancer quality care along with the understanding value based payment systems: Centers for Medicare and Medicaid (CMS) Quality Programs, Medicare Access and CHIP Reauthorization Act, and Merit-based Incentive Programs.

The meeting’s first presentation began with Adam F. Binder, MD, Assistant Professor and Chief Quality Officer for Department of Oncology from the Albert Einstein Cancer Center, Montefiore Medical Center, where he described his experiences with developing an oncology training program for APPs to facilitate engagement of mid-level providers into the oncology academic practice. A needs assessment tool helped provide a tailored continuing education program with the goals of improving job satisfaction by eliminating knowledge gaps and increasing APPs confidence in managing clinical scenarios.

The education curriculum for the hematology/oncology advanced practice providers includes a case-based lecture series provided by speakers who were subspecialists in the field, using recorded lectures posted on a private YouTube channel that APPs can watch if they were unable to attend the lectures. In addition, ongoing modifications are made to the curriculum based on feedback collected after each presentation. The education program improved APP satisfaction with educational activities and helped to improve attendance at other lecture series offered at the institution.

Deborah K. Mayer, PhD, ANP-BC, AOCN, FAAN, Professor, School of Nursing at the University of North Carolina at Chapel Hill School of Nursing and Director of Cancer Survivorship at the UNC Lineberger Comprehensive Cancer Center University of North Carolina-Chapel Hill provided a presentation on the role of advanced practice nursing in cancer quality. Dr. Mayer addressed cancer trends over the next 10 years and the impact on the health care delivery system of an increase in cancer patient survivor care. Due to exponential growth in the number of cancer survivors, cancer centers will need to change how and where care is delivered and who provides follow-up care to them. APPs can be a part of the solution. Cancer center leaders can support APPs in obtaining the knowledge and skills to provide quality cancer care utilizing organizations such as the Oncology Nursing Society and the American Society of Clinical Oncology (ASCO), both of which provide APP education and support programs.

Therese Mulvey, MD, FASCO, Director, Quality, Safety and Value at the Massachusetts General Hospital Cancer Center and Affiliated Networks, provided a presentation on, “All You Wanted to Know about Value Based Payment Systems: Centers for Medicare and Medicaid Quality Programs: Medicare Access and CHIP Authorization Act (MACRA) and Merit-based Incentive Programs (MIPS)”.

Dr. Mulvey discussed the challenges faced by practices that are transitioning from fee-for-service to value-based payment models, and she highlighted various quality payment programs (QPP), MIPs and alternative payment models. She discussed how QPPs will affect physician services participating in Medicare part B programs and who is exempt from participation. She also explained how quality scores are calculated and their impact on payments, as well as the MIPS performance measure categories providers can choose from when opting to participating in a QPP. She provided information about ASCO’s QOPI Clinical Data Registry Program (CDRP), a CMS-approved CDRP which tracks 16 quality measures (13 MIPS approved measures) for 2017 reporting, and she encouraged providers to participate in this program if a transition plan is not in place. She also encouraged members to make every quality patient activity count, which can include: a personalized plan for high-risk patients; integration of patient goals, values and priorities; and documenting patient-specific education and chemotherapy plans.

The meeting included interactive audience participation in the form of a quality quiz, and prizes for participants who provided the most correct answers. The meeting concluded with a panel discussion moderated by PCLI Steering Committee Chair Randall Holcombe, MD, MBA, director of the University of Hawai’i Cancer Center.

More information about PCLI is available at aaci-cancer.org/pcli.asp.