In 2020 the Association of Group Cancer Facilities (ACCC) established the Alternate Payment Design Coalition to deal with worries about deficiency of preparedness to execute beneath alternate payment versions (APMs), affected person and supplier obtain to the hottest treatments, infrastructure, and long-term sustainability. This coalition is inclusive of medical, radiation, and surgical oncology and all respective APMs, which include the Oncology Care Model (OCM) and the proposed Oncology Care Very first (OCF) Model, the Merit-primarily based Incentive Payment Method (MIPS), Medicare Gain, Medicaid Managed Care, and accountable treatment companies (ACOs). Precisely, this initiative seeks to:
- Gain important insights into how APMs effects most cancers treatment supply, the oncology workforce, and people
- Serve as a clearing home for applications and techniques for applying and enhancing APMs
- Aid collaboration and sharing of experiences in between most cancers plans and procedures similar to APMs
- Continue on to present constructive responses to APM developers, these kinds of as the Centre for Medicare & Medicaid Innovation (the Innovation Centre), about concerns pertinent to cancer courses and exercise
APM Implementation Checklist
As the well being treatment field moves from quantity- to value-primarily based care, readiness and approaches for APMs is top of head for most cancers packages and methods. In 2021, ACCC formulated a checklist to help these plans and procedures have an understanding of how their current abilities align alongside the APM continuum from acquiring (ie, just getting started out) to developed (ie, a long time of APM encounter). This tool can support determine the suitable amount of threat dependent on their existing capabilities and identify extra abilities and competencies vital to evolve and/or improve their APM technique. To do so, cancer courses and procedures will appraise six vital regions:
- Company Community
- Care Shipping Transformation
- Technological innovation
- Successful Payment Versions
- Supplier Payment
- Group Foundation
Care Supply Transformation
Each of these places are mapped alongside a continuum from developing to developed. So, for example, less than Care Supply Transformation, cancer systems and techniques examine:
- Clinical Benchmarks and Protocols
- Care Coordination
- Affected person Engagement
Medical Expectations and Protocols
At a bare minimum, most cancers courses and tactics just getting started out with APMs should have medical protocols in spot. Those with additional APM encounter should really have proof-primarily based scientific protocols—including a normal evaluate process—and have defined these clinical protocols throughout the care continuum. All those most cancers packages and procedures with many years of APM knowledge beneath their belt not only have in put evidenced-centered clinical protocols but they also be certain that their providers are conscious of and adhere to these protocols. In addition, these medical protocols are defined across the treatment continuum and stratified on possibility factors. Ultimately, most cancers plans and practices skilled with APMs will frequently evaluation and update their clinical protocols.
Cancer systems and tactics coming into into APMs will have to have treatment administration products and services that are shared across businesses, as nicely as offer referral administration and affected individual navigation to help strengthen treatment coordination. All those searching to increase use of APMs usually share treatment administration products and services across company strains, standardize care transitions in just their business, and coordinate with crisis departments. Ultimately, cancer programs and practices with years of APM working experience generally have care administration companies dedicated to the oncology assistance line, standardized treatment transitions throughout care configurations, and ongoing treatment coordination amongst providers across the overall care continuum.
Affected person Engagement
At a minimum amount, most cancers systems and techniques just receiving began with APMs must carry out individual practical experience surveys. All those looking to develop their use of APMs will generally want to goal their affected individual engagement system to unique initiatives, assure that affected individual knowledge survey success support that engagement system, and keep track of affected person-noted results (Professionals). Cancer applications and tactics with APM knowledge typically have in put a in depth affected person engagement approach, discussion boards this kind of as Patient and Relatives Advisory Councils, and a process to detect actionable things based mostly on their determined Professionals.
Up coming Measures on the APM Journey
This APM Implementation Checklist is not a comprehensive tool but as a substitute really should be used to complement ACCC’s 2020 APM eLearning modules. The eLearning modules—which spotlight serious-world circumstance studies—align with the 6 important regions identified in the checklist, and offer a lot more facts about implementation, which include the sequencing and pacing of treatment transformation. These sources are accessible on the ACCC eLearning portal at accc-most cancers.org/apmc-elearning-modules.