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A recent symposium on Palliative Care in Oncology also called attention to the importance of ensuring that the needs of cancer patients’ caregivers are recognized. “Despite providing essential home and healthcare services, cancer caregivers are underserved and undervalued while facing a multitude of unmet needs,” said J. Nicholas Dionne-Odom, PhD, RN, ACHPN, of the University of Alabama at Birmingham School of Nursing. “There are 2.8 million cancer caregivers performing a variety of invaluable and time-consuming tasks that can take a marked toll on their physical and mental health.” 1  Caregivers are tasked with daily activities in the home and at work, potentially ...
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Pain relating to a cancer diagnosis is one of the most feared symptoms by patients. Pain is subjective and can be attributed to multiple factors: spiritual beliefs, physical pain, and psychological, or social issues. Additionally, pain is a common occurrence that can dramatically affect a patient’s quality of life during and after cancer treatment. A 1993 study performed by the Eastern Cooperative Oncology Group  (ECOG) notes that 86% of practitioners felt their patients were under-medicated for adequate pain control and only 51% felt their practice controls patients’ pain effectively. Poor pain assessment, a practitioner’s reluctance to prescribe, ...
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On May 4, 2017, the U.S. House of Representatives narrowly passed the American Health Care Act (AHCA) , a bill that would repeal and replace key portions of the Affordable Care Act (ACA). The bill now heads to the Senate, where it faces significant concerns over the projected decrease in coverage and increase in cost, and will likely undergo a substantial re-write. While the bill faces uncertainty, the Association of Community Cancer Centers (ACCC) remains very concerned about the impact the AHCA, as currently written, would have on cancer patients’ ability to access comprehensive, affordable health insurance coverage. The bill violates a number of ACCC’s ...
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Several years ago, I facilitated a Patient and Family Advisory Council at our cancer center.  Our patients and families provided us with great insight on our program and helped us create our yearly goals.  On one occasion, one of our family members said, “Hey, what about us? The patients get these great journals, but we need resources too.”  This became our next project.   Two important takeaways from our experience: Don’t Reinvent the Wheel: In creating a toolkit for caregivers, first keep in mind that there are excellent caregiver resources available through national organizations, so there is no reason to reinvent the wheel. Be Concise: ...
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We are now 10 months into the groundbreaking Center for Medicare and Medicaid Innovation (CMMI) Oncology Care Model (OCM) . Just a few weeks ago during the ACCC 43 rd Annual Meeting , a number of OCM practices came together to share updates, pain points and successes, and to collaborate on innovative approaches to meeting OCM requirements during ACCC’s OCM Workshop. Shaping Up Participation in the OCM has been likened to “training for a marathon,” requiring cancer programs to do an honest self-assessment of their financial and operational capabilities, and double down on their investment in workflows, staffing, and data collection—all while trying ...
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Drug pricing reform is in the news again this week as the Medicare Payment Advisory Commission (MedPAC) voted unanimously April 6 in support of the Commission’s multi-part Part B recommendations that include a Drug Value Program (DVP) with elements that align with President Trump’s interest in requiring drug companies to bid for government business. “Despite Trump’s outreach to industry leaders and declaration of support for reducing drug prices, any attempt at price reform will be hard fought,” Jessica Turgon, MBA, ECG Management Consultants, told attendees last week at the ACCC 43rd Annual Meeting, CANCERSCAPE . The “how” of executing drug pricing ...
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The mantra of moving from volume to value is ubiquitous in healthcare today. So what do cancer programs need to know about evolving value frameworks in oncology? Attendees at the ACCC 43 rd Annual Meeting, CANCERSCAPE , in Washington, D.C., heard real-time updates on two of the leading frameworksASCOs work-in-progress Value Framework and NCCNs Evidence Blocks(tm). Both value frameworks aim to be tools used in support of patient―physician shared decision-making according to panelists Stephen Grubbs, MD, FASCO, Vice President of Clinical Affairs, American Society of Clinical Oncology , and Robert Carlson, MD, CEO, National Comprehensive Cancer Network. ...
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Last weeks events on Capitol Hill provided a dramatic backdrop for the ACCC 43 rd Annual Meeting, CANCERSCAPE, March 29-31, bringing together hundreds of oncology professionals from around the country for insights, strategies, and perspective in the midst of healthcare reform ambiguities. In a keynote session Thursday morning, policy insiders Kavita Patel, MD, MS, of The Brookings Institution , and Dan Todd, JD, Todd Strategy, LLC , shared insights on possible next steps toward Affordable Care Act (ACA) repeal or repair under the Trump Administration. ACCC Health Policy Director Leah Ralph moderated the point-counterpoint discussion covering what went ...
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On Capitol Hill yesterday, in nearly 100 meetings with legislators and staff, ACCC advocates spoke out sharing the real-world impact of policy on cancer patients and cancer care delivery in communities across the country. Walking the halls of Congress were ACCC member physicians, nurses, administrators, pharmacists, social workers, financial advocates, and other members of the care teamfrom cancer programs and practices large and smallrepresenting 23 states. In conversations with legislators ACCC advocates urged that Congress: Protect patient access to care, encompassing access to comprehensive affordable insurance coverage Maintain meaningful ...
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Based on evidence presented in the Institute of Medicines 2008 report, Cancer Care for the Whole Patient: Meeting Psychosocial Health Needs , the American College of Surgeons Commission on Cancer (CoC) has phased in a new standard 3.2: Psychosocial Distress Screening . The goal of utilizing a psychosocial distress screening tool is to ensure patients emotional and psychological needs are being addressed in addition to their physical disease and symptoms. CoC Standard 3.2 includes the following description of the psychosocial assessment: This assessment will confirm the presence of physical, psychological, social, spiritual [emphasis added], and financial ...
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ACCC Capitol Hill Day 2017 happens to coincide with national Social Work Month, which the National Association of Social Workers is marking with theme Social Workers Stand Up . As an oncology social worker, this year Im putting on my patient advocates hat, standing up, and going to Capitol Hill to share with legislators the stories of how my patients are being impacting by worry and uncertainty about how changes to the Affordable Care Act and the Medicaid program may affect their insurance coverage and access to care. My home state of Maine has the distinction of having the oldest population in the country per capita and Knox County, where I live ...
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March is National Social Work Month. This year, the National Association of Social Workers theme is Social Workers Stand Up. This is a time to acknowledge the contributions of all social workers. Some social workers are part of a team, others work independentlyall are patient centered in their approach to care. Oncology social workers are part of this proud groupbut our work differs in several ways. While masters degree prepared social workers are trained in assessing the psychosocial needs of their clients and in provision of a range of services, oncology social workers often have additional expertise and specialized clinical training in the meaning ...
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As the move to value-based care and Alternative Payment Models (APMs) continues, oncology patient navigators need to become more business savvy and have a full understanding about value-based cancer care metrics. Case in point: Medicares Oncology Care Model (OCM) pilot, the first oncology-specific alternative payment model developed by the Center for Medicare and Medicaid Innovation (CMMI). Data collection and reporting metrics are integral elements of this five-year pilot program, which seeks to achieve higher quality, more highly coordinated care, and smarter spending. The challenge: Navigation programs lacked strong evidence-based metrics to demonstrate ...
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Do you have a Registered Dietitian Nutritionist (RDN) in your cancer center? If notor if your RDN staffing is limitedyou may be interested in what an RDN can do for your patients. First, Some Background What does it take to earn the RDN credential? To be a Registered Dietitian Nutritionist, you must first obtain, at a minimum, a bachelors degree in Nutrition from an accredited program. Next, you must complete a minimum of 1,200 hours of RDN-supervised practice in various settings including clinical, community, and food service rotations, among others. In the near future, a masters degree will be the minimum required education, and currently ...
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Speak Up Now!

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For this years ACCC Capitol Hill Day, Wednesday, March 29, ACCC advocates will descend on Washington, D.C., with newfound motivation. As Congress grapples with the future of the Affordable Care Act (ACA) and debates the merits of protecting patients with pre-existing conditions vs. high-risk pools, refundable tax credits vs. subsidies, requirements for essential health benefits vs. more flexibility in benefit standards, oncology care providers see insurance coverageand their patients access to cancer careat stake. Yes, Its Complicated The political messagingnot to mention policy minutiaeis difficult to sort through, even for the wonkiest of policy wonks ...
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The National Cancer Registrars Association (NCRA) recently asked members on its Facebook page, Is tumor registry an outdated term? The responses were spirited and detailed the ways tumor registry and the Certified Tumor Registrar (CTR) credential can be confusing. For example, NCRA members noted that some of their colleagues and patients think they help patients register for treatment or that a CTR certifies tumors. There was a strong sense that the current terminology belittles what cancer registrars do, or gives the impression the work is less technically sophisticated than it is. In a time when registrars are struggling to defend the profession from ...
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Last June, the Centers for Medicare & Medicaid Services (CMS) announced that nearly 200 physician group practices and 17 health insurance companies had been selected to participate in the Oncology Care Model (OCM), the first oncology-specific alternative payment model (APM) pilot. (According to the latest information on the OCM website, participant numbers now stand at 190 practices and 16 payers.) At about 7 months into this brave new world, participants are beginning to share some lesson learned. At last weeks Cancer Center Business Summit in Las Vegas, a panel discussion on The Oncology Care Model: Evolving Best Practices, shed light on some of the ...
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While there can be no single roadmap for transitioning to value-based care, a panel session at the 2017 Cancer Business Summit, February 6-7, 2017, co-hosted by the Association of Community Cancer Centers, focused on Operational & Cultural Change that can help cancer programs move forward on the path ahead. Sarah Chavarria, Chief People Officer, NantHealth, shared that successful organizational alignment is centered around these key concepts: Strategy: mission, vision, and values; organizational goals; brand. Structure: placing the right talent in the right role; holding people accountable for meeting organizational goals. Talent: managing ...
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Last week in Las Vegas, the Association of Community Cancer Centers (ACCC) co-hosted the 2017 Cancer Center Business Summit, a two-day conference focused on how the business of oncology is being transformed by the dual drivers of science and technology. Featured speakers and panelists from cancer programs, technology innovators, patient advocate groups, and payers came together to explore how new technology impacts the delivery and future of cancer care. Session topics highlighted clinical pathways, advanced alternative payment models (APMs), patient-centered care, genomic science, and more. Below are highlights from three conference sessions. A session ...
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In a feature article in the January/February edition of Oncology Issues , Patsy Astarita, LCSW-C, OSW-C, and Michelle Abramowski, MSN, CRNP, share how the Kaufman Cancer Center in north central Maryland developed a palliative care program from the inside out. Though the existing infrastructure of the Kaufman Cancer Center included some palliative care resources, their challenges in developing the program were similar to those faced by other cancer programs: a dearth of existing funding, a navigation program focused on newly diagnosed patients rather than those at the end of life, and limited outpatient palliative care resources, among others. Despite ...
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