During the past 12 months, an extraordinary level of activity and progress occurred in cancer-related policy and practice activities. From physician reimbursement and federal research funding to interoperability of electronic health records and value in cancer care, 2015 was a watershed year for how the cancer care environment will be structured in the future.
The coming year will be just as consequential, but we are sharing with you some 2015 highlights—and ASCO’s center-stage role in shaping a practice environment where patients with cancer can receive the highest quality, highest value care.
State of Cancer Care in America. ASCO’s annual policy report showed that the U.S. cancer care system continues to face tremendous turbulence while dealing with growing numbers of cancer patients and survivors, mounting pressures to control rising healthcare costs, and widespread oncology practice transformation. Receiving broad media coverage, the 2015 State of Cancer Care in America report set forth a series of recommendations to address the disruption occurring in the national cancer care system and ensure that all patients with cancer have access to high-quality care.
SGR Repeal. On April 14, 2015, the U.S. Senate passed the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), repealing the Sustainable Growth Rate (SGR) formula and ending a 13-year roller coaster ride for Medicare beneficiaries and their physicians. ASCO long-advocated for repeal of this fundamentally flawed formula and adoption of a more reliable payment system that reflects the reality and cost of today's oncology practice—ensuring access to high-quality cancer care for all Medicare beneficiaries.
MACRA. The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) lays out far-reaching changes and an ambitious implementation schedule that will profoundly impact reporting Medicare requirements for and reimbursement to oncology practices. To begin preparing its members for MACRA, ASCO leadership from ASCO’s Clinical Practice Committee, Government Relations Committee, Quality of Care Committee, and State Affiliate Council developed a blueprint for the society's involvement in the new law’s implementation. ASCO will provide a wide range of continually updated resources and tools that are designed to help practicing oncologists satisfy MACRA requirements and move toward a value-based practice environment.
Payment Reform. Developed by a dedicated group of ASCO volunteers representing all practice settings, the Society released its Patient-Centered Oncology Payment reform model, which is designed to provide sufficient payment to support the full range of services that cancer patients need and removing the barriers created by the current payment system to delivering high-quality, affordable care.
Value Framework. ASCO led the way on the national discussion on value in cancer care when it released its conceptual framework for assessing the value of new cancer therapies based on treatment benefits, toxicities, and costs. Developed by the ASCO Value in Cancer Care Task Force, the framework will ultimately serve as the basis for user-friendly, standardized tools that physicians can use in the clinical setting with their patients to discuss the relative value of new cancer therapies as compared with established treatments.
Site Neutral Payments. ASCO called for comprehensive physician payment reform to support the full scope of services required by patients with cancer, rather than jeopardizing patient outcomes by reducing the available resources in a particular cancer care setting in an effort to achieve “site neutrality” in reimbursement for oncology services. In a new policy statement on site-neutral payments in oncology, ASCO asserted that the traditional approach to physician payment under Medicare is flawed and reflects a narrow and outdated view of the needs of individuals with cancer and the best available options for delivering high-quality, high-value care.
TAPUR. In June, ASCO announced the launch of the Targeted Agent and Profiling Utilization Registry (TAPUR) study, the society’s first-ever clinical trial. TAPUR will offer patients with advanced cancer access to molecularly-targeted cancer drugs and collect “real-world” data on clinical outcomes to help learn the best uses of these drugs outside of indications approved by the Food and Drug Administration (FDA). Plans for TAPUR, including the participation of major pharmaceutical companies that will contribute free drugs, were released in a news briefing at ASCO’s 2015 Annual Meeting in Chicago. An Institutional Review Board will review the study protocol and consent form and ASCO plans to begin recruiting patients in 2016.
EHR Interoperability. ASCO continues to raise awareness and advocate on the issue of developing and using interoperability standards for exchanging health information. The Society provided input and supported the interoperability provisions in the 21st Century Cures legislation, which passed the House of Representatives in July. Then in September, ASCO outlined steps Congress should take to advance the widespread interoperability of electronic health records (EHRs) and prevent the practice of “information blocking.” The recommendations were outlined in an ASCO position statement released during a Capitol Hill briefing on big data during which the Society also described its vision for CancerLinQ™, a health information technology (HIT) platform that will harness big data analytics to help oncologists deliver high-quality care to patients with cancer.
Oncology Census. Nearly 2,200 practices, representing nearly 14,000 oncologists, participated in this year’s National Oncology Census. Data from the Census will be chronicled in ASCO’s publication, The State of Cancer Care in America: 2016 and insights from the data will help guide ASCO’s policy and advocacy efforts.
NIH Funding. ASCO continues to advocate for increased funding for the National Institutes of Health (NIH) and National Cancer Institute (NCI). The 21st Century Cures legislation includes more than $8 billion in mandatory additional funding for NIH. In addition, ASCO continues to call for increased funding for NIH and NCI for Fiscal Year 2016 through directly contacting key members of Congress and opinion pieces in both The Hill and Research!America’s blog.
ASCO Clinical Affairs Department. ASCO’s newly-launched Clinical Affairs department continues to provide boots-on-the-ground support to oncology practices. In July, Stephen S. Grubbs, MD, a community oncologist and managing partner at Medical Oncology Hematology Consultants, PA, in Newark, Del., became the Senior Director of the newly established department. Clinical Affairs will provide support to oncology professionals around the country in the areas of business analytics, performance improvement, and practice management with the ultimate aim of fostering more effective and efficient delivery of cancer care for the benefit of patients.
PracticeNET. In May, ASCO launched PracticeNET, a collaborative network in which practices will share and receive insights to enhance their business operations and quality of care. PracticeNET is the first initiative of the Clinical Affairs Department. ASCO is currently recruiting practices for PracticeNET. Participating practices will submit business, operational, administrative and quality data on a monthly basis and will receive quarterly reports measuring their practice and individual physicians against the database of PracticeNET participants. They will also receive an annual “state of your practice” assessment on key production and cost measurements and will be able to request reports to meet their individual practice needs.
Throughout 2016, ASCO in Action will continue to bring you the latest news, advocacy opportunities, and objective analyses on cancer-related policy developments—to keep you fully informed and engaged in the critical issues that will impact your oncology practice and patients. Stay tuned to ascoaction.asco.org.