2. Building the Oncology Medical Home

3. Panelists Moderator: Gordon Kuntz, Senior Director, Payer Solutions, ION Solutions Panelists: Susan Tofani, MS, Director Network and Payer Relations, Oncology Management Services, Inc. Tracey F. Weisberg, M.D., Medical Oncologist, Maine Center for Cancer Medicine

4. Building the Oncology Medical Home Tracey F. Weisberg MD Maine Center for Cancer Medicine

5. Disclosure Information Tracey F. Weisberg, M.D. Employment or Leadership Position: Maine Center for Cancer, President Please note, all disclosures are reported as submitted to the Cancer Center Business Summit and are available at cancerbusinesssummit.com.

6. MCCM Overview Private physician-owned practice for over 30 years Operations in four sites and staff three rural clinics QOPI certified all four infusion sites 14 physicians – 13 medical oncologists – 1 internal medicine hospitalist – 3 physicians boarded in palliative care – 8 midlevel providers

7. MCCM Programs Contract with Maine Health to deliver education to medical residents, oversee operations of Thoracic Oncology Clinic, Brain Tumor Clinic, Breast Clinic, hospital IV therapy Hemophilia Clinic Research Program Cancer Genetics Survivorship program Palliative Care (inpatient and outpatient consultation) Physician dispensing

8. MCCM Vision To provide the highest quality, cost effective cancer care in the region Optimize cancer treatment outcomes with early integration of pathways, early adoption of new technology and treatment strategies, and continued dedication to cancer research Patient-centered care

10. Treatment and Urgent Care Pathways with Data Collection

11. COME HOME Be present for the patient at the time of their greatest need

12. Work to the peak of your licensure

13. Challenges MCCM for 30 years used a primary nurse model Physicians enthusiastic, staff skeptical Staff concern about having to work more NP concern about needing to work extended hours Lead nurse could not envision change Phone system revision Perceived rigidity of following an urgent care pathway….we know how to do this already Implementation of urgent care hours Data collection with new software system

14. Frustration Leads to Breakthrough…….

15. We have a new nursing council Our patients love the extended hours. Families have been grateful not to have ER visits and waits Physician on-call perhaps a bit lighter We have new vision about our employee-patient relationship Hospital wants to use our data to demonstrate that they are working to reduce ER visits etc Payers interested in new model

16. Building the Oncology Medical Home Susan H. Tofani Oncology Management Services, Ltd.

17. Disclosure Information Susan Tofani, MS Employment or Leadership Position: Oncology Management Services, Ltd. Honoraria: ION Solutions Please note, all disclosures are reported as submitted to the Cancer Center Business Summit and are available at cancerbusinesssummit.com.

18. Not for redistribution.© 2013 Oncology Management Services, Ltd Building the Oncology Medical Home Topics to address Why change… What is it… How to get started… What are the critical components… Where to look for help…

19. Not for redistribution.© 2013 Oncology Management Services, Ltd Why Change… Preserve and / or enhance revenue Movement to value-based purchasing (Value = Quality / Cost) Improve patient experience Patient – family engagement Improve operational efficiencies Overhead costs Operational costs Continuous process improvement

20. Not for redistribution.© 2013 Oncology Management Services, Ltd Top 10 Lists for 2013 Top Challenges For Mid-Size Hospitals and Health Systems 1. Physician Alignment/Clinical Integration 2. Cost Control 3. Measuring Outcomes/Operational Efficiencies 4. Census/Patient Volume 5. Reimbursement Reductions 6. EHR/Technology 7. Patient Satisfaction/HCAHPS 8. MD/RN Recruitment 9. Cross-Continuum Partnerships 10. Value-Based Purchasing 11. New Revenue Sources Top Strategic Priorities for Healthcare Providers (Practices) 1.Improve patient care/patient satisfaction 2.Grow practice/find new revenue opportunities 3.Reduce operational or overhead costs 4.Increase staff productivity 5. Implement/improve workflow 6.Implement/improve an EHR/EMR system 7. Improve risk management and compliance 8.Improve overall technical skill level of staff 9.Implement/improve new IT equipment 10.Implement/improve other software systems Source: 4th Annual Healthcare IT Insights and Opportunities Source: Community Hospital 100

21. Not for redistribution.© 2013 Oncology Management Services, Ltd Oncology Patient Centered Medical Home® What is it… Model of Oncology Care Ownership of all aspects of cancer care delivery – Pre-treatment consultation, plan of care – Patient access, engagement & shared decision-making – Treatment coordination & execution – Palliation of symptoms – End of Life Care – Survivorship Care

22. Not for redistribution.© 2013 Oncology Management Services, Ltd Outcome Measures Patient- & Payer-Centered Patient Experience AHRQ CAHPS: Consumer Assessment of Healthcare Providers and Systems Outcomes Staging compliance Chemotherapy guideline adherence Emergency Room evaluations Hospital admissions / length of stay Outpatient visit reduction End of Life Care parameters Diagnostics: imaging & laboratory

23. Not for redistribution.© 2013 Oncology Management Services, Ltd Resulting in Practice Efficiencies Reduced staff FTE / physician FTE Increased patient volume Engaged staff working at the top of their respective licenses Fewer physician disruptions Merger of clinical work flow with technology

24. Not for redistribution.© 2013 Oncology Management Services, Ltd How to get started… Begin with the end in mind – Stephen Covey Select the project team – Physician champion Research models, evidence-based and best practices Evaluate your capabilities and capacity – Leadership, decision-making, care-team culture, infrastructure Determine your approach – Self-study / self-guided – Seminar / workshop – Hands-on assistance

25. Not for redistribution.© 2013 Oncology Management Services, Ltd Building a Home Streamline Declutter Empty Nester Remodel/ repurpose Buy signature pieces Build an addition Move Growing Family Apartment /First House Sparse Furnishings / Thrift store finds / Empty Rooms Starting Out

26. Not for redistribution.© 2013 Oncology Management Services, Ltd Building a Medical Home Streamline Continuous Improvement Optimization Revised roles, reporting and processes Add services Integrate workflow and IT Growing Pains Legacy processes Culture Economic Challenges Starting Out

27. Not for redistribution.© 2013 Oncology Management Services, Ltd What are the critical components… Maximize potential of IT systems Efficient Physician-led care teams Patient and family engagement Standardized processes Coordination and Communication Performance Measurement and Improvement

28. Not for redistribution.© 2013 Oncology Management Services, Ltd Where to look for help… Building a HomeBuilding a Medical Home IdeasStores, magazines, Pinterest, friends, open houses, model homes Professional groups / meetings, journals, other practices, payers, demonstration projects ScaleRepurpose, remodel, build an addition, or move Redesign roles and workflow, implement an EMR, add services, standardize policies, enter into payer projects and / or pursue recognition ApproachDIY, buy tools, engage a contractor, hire an architect, move to new house DIY, attend workshops, buy tools / technology, engage a consultant

29. Not for redistribution.© 2013 Oncology Management Services, Ltd Where to look for help… ION Solutions – Practical Guide for Building Value Oncology Management Services (OMS) American Society of Clinical Oncology (ASCO) National Comprehensive Cancer Network (NCCN) National Coalition on Cancer Survivorship (NCCS) Community Oncology Alliance (COA) American College of Physicians (ACP) National Committee on Quality Assurance (NCQA) Patient Centered Specialty Practice

30. Not for redistribution.© 2013 Oncology Management Services, Ltd Thank you Susan Tofani Oncology Management Services stofani@oms-support.com 215-817-7957 www.opcmh.com