Blogs

Be the first person to recommend this.
On August 21, 2017, ACCC submitted comments to the Centers for Medicare & Medicaid Services (CMS) regarding the agency’s  proposed 2018 updates  to the Quality Payment Program (QPP), a two-track value-based reimbursement system created by the Medicare Access and CHIP Reauthorization Act (MACRA). The two tracks in which eligible clinicians can opt to participate are the enhanced fee-for-service based  Merit-Based Incentive Payment System (MIPS)  and  Advanced Alternative Payment Models (APMs) , which require clinicians to take on more than nominal risk. Under the QPP, 2017 performance will affect Medicare payments for all eligible clinicians in 2019. While ...
0 comments
Be the first person to recommend this.
Here in Washington, D.C., as we count down the days remaining in the Congressional August recess, the Centers for Medicare & Medicaid Services (CMS) has reminded us that big changes in healthcare are not limited to the political brinkmanship of ACA repeal. On July 13, 2017, the agency released its CY 2018   proposed Hospital Outpatient Prospective Payment System (OPPS)   and   Physician Fee Schedule (PFS)   rules. The proposed OPPS rule was the big news this year, signaling major changes may be in store for hospital reimbursement in 2018. The agency is proposing significant reduction in payment for drugs purchased under the 340B Drug Pricing Program and ...
0 comments
Be the first person to recommend this.
As we continue to better understand the many diseases encompassed under the name, “cancer,” we are also seeing an increase in the number and complexity of anti-cancer treatments. These exciting advances are taking place while cancer programs are striving to empower patients with education about their diagnosis and treatment journey and continually improve the patient experience of care. In this guest blog post, Dr. James Weese, vice president, Aurora Cancer Care, describes his program’s   2017 ACCC Innovator Award   winning approach. The Challenge Oncologists, nurses, and other cancer care staff across the country work tirelessly to find the best way ...
0 comments
1 person recommends this.
Healthcare professionals are known for hiding their grief. There is an unspoken (though outdated!) code that we must be strong. Or, put another way, that we just need to get used to it. But with increased recognition of the high risk for burnout among healthcare professionals, this “old code” is coming under scrutiny. Writing about “professional grief,” Elizabeth Clark, PhD, ACSW, MPH, former executive director of the   National Association of Social Workers   observes that “professional grief is generally hidden grief, grief that is internalized and not openly expressed . . . . There’s no natural outlet and demands of work overshadow it.” Grief that ...
0 comments
Be the first person to recommend this.
Despite much debate, healthcare reform remains in flux in Washington after a round of critical votes in the U.S. Senate this week. In the latest effort to repeal the Affordable Care Act (ACA), on Tuesday, July 25, the U.S. Senate voted 51-50, with Vice President Mike Pence breaking the tie vote, for a motion to proceed, which set up a process allowing for open debate and amendments to the AHCA, the House version of ACA repeal, on the Senate floor. On Tuesday evening, the U.S. Senate brought to the floor their latest version of the Better Care Reconciliation Act (BCRA) with the added Cruz Amendment, allowing for sale of low-cost insurance plans if insurance ...
0 comments
Be the first person to recommend this.
This week, the U.S. House of Representatives Subcommittee on Oversight and Investigations, of the Energy and Commerce Committee, chaired by Rep. Tim Murphy (R-PA), held a hearing titled, “Examining HRSA’s Oversight of the 340B Drug Pricing Program.”   Health Resources and Services Administration (HRSA)   is the agency within the U.S. Department of Health and Human Services that currently oversees the   340B Drug Pricing Program . The program’s inception in 1992 sought to provide discounted outpatient drugs to “covered entities” (DSH facilities, rural referral centers, freestanding cancer centers, non-profit hospitals, etc.) who provide a certain level of ...
0 comments
Be the first person to recommend this.
At the end of last week, it was anticipated that the U.S. Senate would hold a vote on the Senate Republicans’   revised version   of the Better Care Reconciliation Act (BCRA) today, Tuesday, July 18. However, over the weekend,  Senator John McCain (R-AZ) underwent an emergency surgery and Senate Majority Leader Mitch McConnell (R-KY) announced that the vote on BCRA would be postponed until Senator McCain’s return to Washington, D.C. With two Senators, Rand Paul (R-KY) and Susan Collins (R-ME), already openly opposed to voting ‘Yes’ on BCRA—Senator McCain’s absence would have put the Republican Senators’ vote on the bill at risk. In order to continue the ...
0 comments
Be the first person to recommend this.
It’s been quite a week in Washington, D.C.  Let’s recap. On Wednesday, July 12, the Centers for Medicare & Medicaid Services (CMS) held the latest in a series of webinars explaining the agency’s   proposed rule   for CY 2018 updates to MACRA’s Quality Payment Program. If you missed ACCC’s webinar on the implications of this proposed rule, members can   access the webinar, presentation slides, and a summary [login required] . On Thursday morning, July 13, U.S. Senate Republicans unveiled their  revised draft  of the Better Care Reconciliation Act of 2017 (BCRA). The updated bill is the latest effort to repeal and replace the Affordable Care Act ...
0 comments
Be the first person to recommend this.
       “I want to be aware of the navigator and support services as soon as possible.” This is a frequent response from patients when asked about the optimum point in the cancer care journey to learn about navigation and support services. And yet, during a first visit (or intake interview) with a patient, navigators may question how much to review. Where is the balance between too much information and not enough?  Based on my experience in care coordination and patient navigation, here’s my perspective on creating and using an intake assessment tool. Number 1 Rule:  Assess if the patient is ready for this discussion.   First, provide support. ...
0 comments
Be the first person to recommend this.
For more than 30 years the world of oncology nursing and the patients we care for has been bound by the expectations of the known effects of chemotherapy on the human body. While these toxicities can be difficult and, at times, even life threatening, for the most part they are predictable. As experienced oncology nurses, we know that after a certain number of days the patient blood counts will likely drop. Our patients being treated with chemotherapy anticipate that they may experience nausea, diarrhea, bone pain, and other side effects. For the most part, with chemotherapy we can expect a logical start, progression, and end to toxicities. Immuno-Oncology ...
0 comments
Be the first person to recommend this.
Last Thursday, June 22, Senate Republicans publicly unveiled their discussion draft legislation titled, the Better Care Reconciliation Act —their version of the House’s recently passed American Health Care Act (AHCA) (H.R. 1628). Neither bill was drafted under regular order, as Republicans try to maintain steam in pushing forward with the repeal and replacement of the Affordable Care Act (ACA). Unfortunately, for multiple stakeholders, including many of those within the cancer care community, it is questionable how much the Republican Caucus sought patient and provider feedback to incorporate into their bills. Although there was much speculation that the ...
0 comments
Be the first person to recommend this.
Unfortunately, nurse navigation services are typically non-revenue generating, necessitating a cost/benefit evaluation of these services for many programs. To justify nurse navigation in this new era of value-based care, we must define appropriate caseload volumes through risk stratification, and determine how best to allocate nurse navigation time and resources among those caseloads. How Best to Measure & Define Acuity? Acuity tools have been used in healthcare for decades and have proven successful as a means of determining staffing needs, improving patient care, and controlling costs.  Most acuity tools score patients on a scale of specific ...
0 comments
Be the first person to recommend this.
Once again immuno-oncology (I-O) was center stage at this year’s American Society of Clinical Oncology (ASCO) Annual Meeting (June 2-6, 2017) where more than 250 presentations featured checkpoint inhibitors. Currently, six immune checkpoint inhibitors have received FDA approval for more than nine cancers, with more than 1,000 studies in progress. On June 2 at ASCO, two pre-eminent immunotherapy investigators provided perspective on the rapidly evolving immuno-oncology landscape with a look back and a look to the future.  During their presentation, “On the Shoulders of Giants: Historical Approaches to Immunotherapy in Solid Tumors,” James P. Allison, PhD, ...
0 comments
Be the first person to recommend this.
Stressed by nurse staffing shortages? Learn how 2017 ACCC Innovator Award winner Loma Linda University Cancer Center tackled this challenge. One of the most challenging issues in healthcare is the ongoing balancing act of staffing and retention. For specialty areas, such as oncology, staffing presents an even more difficult challenge. Finding those perfectly qualified individuals with all the right experience to fill open positions can be a taxing, time-consuming task. As a result, cancer programs may find themselves dealing with lengthy vacancies, which can cause some real strains on a growing clinic and may led to an unhappy environment for nurses ...
0 comments
Be the first person to recommend this.
The ACCC Optimizing Electronic Health Records (EHRs) education initiative aims to identify practical solutions and effective practices to help cancer programs navigate their ongoing journey with EHRs. ACCC convened two focus groups for this project bringing together a diverse group of stakeholders to talk frankly about how their cancer programs are overcoming some of the common EHR challenges that hinder provider efficacy.  Four key themes emerged during these conversations, read on. Coordination of EHRs Across Multiple Locations Given that some cancer programs span multiple locations that offer different services, it remains critical for all ...
0 comments
Be the first person to recommend this.
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 ...
0 comments
Be the first person to recommend this.
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, ...
0 comments
Be the first person to recommend this.
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 ...
0 comments
Be the first person to recommend this.
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: ...
0 comments
Be the first person to recommend this.
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 ...
0 comments