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@justOncology

~ Musings on health, illness & evidence based medicine

@justOncology

Tag Archives: accountable care

What Is Cancer?

09 Friday May 2014

Posted by @JustOncology in Uncategorized

≈ 2 Comments

Tags

accountable care, best practices, evidence based care, health, innovation, jay walker, mind the gap, oncology, stephen wilkins, tedmed, wellness

By Gregg A. Masters, MPH

It’s been a while since Dr. Just has been able to put pen to pad and update you on his journey (and their is lots to tell from group mergers to a continuing drama with EHR implementation) into social media and a ‘transition’ to full to part time practice in a multi-site community oncology practice. More soon from Dr. J aka @chemosabe1 – at least I’ve been told.

Meanwhile, below is a clip producer by Jay Walker the curator of TEDMED and noted Professor of Medicine and Engineering at the University of Southern California Keck School of Medicine and Viterbi School of Engineering oncologist David B, Agus, MD well worth a view!

Also, we had a great session today on ‘this week in oncology’ chatting with Stephen Wilkins the publisher of ‘Mind The Gap’ blog. You can listen here.

 

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Crowds Care for Cancer Challenge: Supporting Survivors the Finalists

25 Tuesday Jun 2013

Posted by @JustOncology in health, health innovation, healthIT, oncology, patient empowerment

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Tags

accountable care, cancer, coordinated care, crowds care for cancer, digital media, health, innovation, integrative oncology, medicine, survivorship

By Gregg A. Masters, MPH

Last month in a continuing commitment to advance the art and science of patient engagement in health the Office of the National Coordinator for Health Information Technology (ONC) teamed up with the National Cancer Institute (NCI) partnering with Health 2.0 Challenge and the Medstartr crowd funding platforms to field an innovative challenge on creating applications for the estimated 14 million cancer survivors in the United States.

Journey Forward: My Care Plan

For complete program details on the the ‘Crowds Care for Cancer: Supporting Survivors‘ challenge click here, and for the finalists now in the crowd funding optimization stage see the Medstartr finalists feature page here.

On This Week in Oncology, we chat with each of the three finalists in the competition, beginning with Journey Forward: My Care Plan, a project by Tiffany Devitt.

On Thursday, June 27th, 2013 at 1:30PM Pacific/4:30PM Eastern to join us live (or for an archived replay) with Patti Ganz, MD of the Journey Forward: My Care Plan team, click here.

PatientsWithPowerTogether AppBoth remaining Crowds Care for Cancer: Supporting Survivors Challenge finalists are scheduled as follows:

PatientWithPower: A project by PatientsWithPower | 11AM Pacific/2PM Eastern Friday, June 28th, 2013. For live or archived replay, click here.

Together: A project by Michelle Longmire | 11AM Pacific/2PM Eastern Tuesday, July 2nd 2013. For live or archived replay, click here. 

Please review each of the candidates in this important challenge and show your support accordingly. The leader board to date is as follows: PatientsWithPower, Journey Forward: My Care Plan followed by Together.

 

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The ‘Oncology ACO’: Does it Have a Future?

26 Monday Nov 2012

Posted by @JustOncology in Uncategorized

≈ 4 Comments

Tags

accountable care, aco, affordable care act, cancer, FloridaBlue, health reform, innovation, obamacare, oncology ACO, US Oncology

By Gregg A. Masters, MPH

The best business model for oncology care is not yet obvious to me. But it is crystal clear that innovative new models are being hatched before our eyes.. via Oncology Times

Since CMS (via HHS) issued the final rule addressing ACO provisions and specifically ‘excluded’ oncologists from participating as ACO organizers, instead relegating their involvement in at least via the Medicare Shared Savings Program to ‘participants’, there has been rumbling underneath the surface of ‘ACO-dom’.

Perhaps as best evidenced by the April announcement of a tripartite venture between FlordiaBlue, Advanced Medical Specialties (a former US Oncology Affiliate now part of the McKesson fold), and Baptist Health System, the competitive positioning in the oncology market is not sitting idly by as other medical specialties, including primary care, carve out their niche and actively experiment with their version and local vision for accountable care aka ‘the triple aim.’

In the broader conversation on ACOs or their derivatives including medical homes or accountable care collaborations, etc, there has been much discussion from very smart and accomplished wonks including periodic banter, i.e., Goldsmith v. De Marco] as to the significance and forward [reasonably expected] benefits from duly organized [or in the latter case – arranged] ACOs. Bottom-line,  there is a fair amount of credible disagreement over whether these entities as variably configured actually make a difference?

Meanwhile, in the oncology domain, much of the action seems relegated to a few forward thinking players who have taken the initiative regardless of CMS’ decision to limit their participation (at least to this point in time) to contracted participant suppliers of specialty services.

For a deeper dive into the question: ‘Who Is Taking the Lead in Incorporating Oncology into ACO Thinking?’ see: The Rapidly Evolving ACO World, we have the following observation and summary data:

There are several examples of organizations that have stepped up and have taken the lead in exploring payment re-design in oncology, some within an ACO shared savings context and some outside the ACO context.

The vanguard includes:

  • Consultants in Medical Oncology & Hematology. Oncology Patient Centered Medical Home®, Drexel Hill, PA
  • United Healthcare (5 episode payment pilot sites)
  • Texas Oncology/Innovent Oncology and Aetna
  • Oncology Physician Resource (OPR) and Michigan Blue Cross
  • Wilshire Oncology and Wellpoint, Southern California
  • CareFirst Blue Cross pathways and medical home initiative, Maryland
  • Priority Health oncology medical home initiative, Michigan
  • Florida Blue, Baptist Health South Florida and Advanced Medical Specialties Oncology ACO, Miami
  • Harvard Pilgrim Health Plan with oncology medical home demonstration pilot, Massachusetts;
  • Innovative Oncology Business Solutions with CMMI Innovation Challenge grant to demonstrate value proposition of community oncology medical home (COME HOME) at 7 community oncology practices nationwide.

And certainly there will be more organizations joining the vanguard in the near future.

We are working on getting Ronald Barkley, CCBD Group, and Linda Bosserman, MD, President and CEO of Wilshire Oncology respectively to share their thoughts on ‘This Week in Oncology’. We’ll keep you posted when we’re able to lock them down.

Meanwhile, with the elections now behind us, the future is rather clear at least for those who want to manifest the spirit and intent of the Affordable Care Act, so ‘warp drive Mr. Zulu’ as the ACO movement shifts into overdrive.

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The ‘incident’

My life was essentially on autopilot. My oncology practice was very successful; in fact, too successful. All my time and energy was devoted to keeping pace with the increasing demands of the profession. Other pursuits, be they personal or professional, always seemed to take a back seat. My main unfulfilled passion was writing.

On January 7, 2011, everything changed. I had a new bovine aortic valve and three new coronary artery grafts. A life altering event, to say the least. Fortunately my recovery has been uneventful, and I had no evidence of muscle injury. So I’m extremely grateful for the pre-emptive surgery, and since I’m back to work on a part time basis, I now can devote some of my attention to writing.

For the past several years, a colleague, trusted advisor and friend of mine, Gregg Masters, had been prodding me to “just do it”, i.e., just start blogging, podcasting and life streaming my experiences in Medicine. He pointed out the value of my 36 years in clinical practice of hematology and medical oncology as 'elder wisdom' currency in relative short supply. In truth, there is certainly a lot to write about as the clinical knowledge base has grown enormously, to the point where management of all this information requires computers. Fortunately, technology has developed at a rapid rate also so that we can not only mine all this data to obtain meaningful information, but better disseminate it to each other, health plans (including government) and especially our patients. With the advent of social media including Twitter, Facebook and You Tube, this flow of information becomes a two way street allowing physicians to listen as well as talk. On a personal note, my wife published daily status updates during my surgery and through the post-operative period on a website called Caringbridge. She posted pictures as well as narrative. Colleagues, relatives, friends and patients had a window opened to them as to how I was doing, and they in turn wrote back notes of encouragement that touched me deeply.

When Gregg and I thought about it, his background not only in 'web 2.0' (social media) but perhaps more significantly his considerable experience in the business aspects of medicine brings value into the conversation as well. In today’s environment, physicians are constantly reminded that we not only are responsible for all aspects of caring for patients, but we are running a business as well. Years ago, I remember reading an excellent book called “The E-Myth Physician” by Michael Gerber. One of the chapters was devoted to the subject of “Money”. So Gregg’s knowledge complements my clinical background resulting in the birth of JustOncology.com.

Certainly there is no shortage of topics to discuss. Utilizing a variety of media: blogging (which addresses my passion for writing), audio and visual interviews with as many of the stakeholders in cancer care as possible, we hope to provide a forum for discussion of problems facing us. From these interactions, the desired outcome is to identify solutions that can only come from a collaborative effort.

Recent Posts

  • In Absentia
  • What Is Cancer?
  • Big Data, Government and Cancer Research: A Benefit for Patients?
  • The Advent of Cancer Immunotherapy: Addressing Unmet Needs Part 1
  • Crowds Care for Cancer Challenge: Supporting Survivors the Finalists
  • Tumor Board: Is There Value in Multidisciplinary Case Consideration?
  • ‘You Don’t Know Jack’ by Morgan Spurlock
  • @IBMwatson and the Future of Oncology Care

About

JustOncology.com is a joint publication of Richard Just, MD, aka @chemosabe1 on Twitter and Gregg Masters, MPH, aka @2healthguru on Twitter.

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