An Optimal Care Coordination Model (OCCM) for Medicaid patients with lung cancer: Finalization of the model and implications for clinical practice in the United States.

Authors

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Randall A. Oyer

Ann B Barshinger Cancer Institute at Penn Medicine Lancaster General Health, Lancaster, PA

Randall A. Oyer, Christopher S. Lathan, Matthew Smeltzer, Amanda Kramar, Leigh Boehmer, Thomas Asfeldt

Organizations

Ann B Barshinger Cancer Institute at Penn Medicine Lancaster General Health, Lancaster, PA, Dana-Farber Cancer Institute, Boston, MA, University of Memphis, School of Public Health, Memphis, TN, Association of Community Cancer Centers, Rockville, MD, Sanford Health, Sioux Falls, SD

Research Funding

Other Foundation
Bristol Myers Squibb Foundation.

Background: In 2016, the Association of Community Cancer Centers (ACCC) launched a 3-year initiative to design, test, and refine an OCCM for Medicaid patients with lung cancer. The aim was to help cancer programs identify and reduce the barriers experienced by Medicaid patients by strengthening lung cancer care delivery systems. Methods: Phase I included Model development. Phases II and III included selection of 7 community-based cancer programs as testing sites to implement quality improvement projects, utilizing qualitative and quantitative assessments. Beta testing demonstrated the Model’s ability to offer practical guidance on improving care coordination to achievable target levels in high-impact areas such as patient access to care, prospective multidisciplinary case planning, and tobacco cessation. Opportunities were identified to improve care coordination beyond lung cancer to other tumor sites. Refinements for clarity of intent, ease of use, specificity, and uniformity across assessment areas were implemented, based on feedback from testing sites. Members of the Technical Expert Panel and the Advisory Committee, ACCC staff, and consultants revised the Model using consensus decision-making. Results: The final OCCM is composed of 12 inter-related assessment areas: patient entry into lung cancer program; multidisciplinary treatment planning; clinical trials; supportive care; survivorship care; financial, transportation, and housing needs; tobacco education; navigation; treatment team integration; physician engagement; electronic health records and patient access to information; and quality measurement and improvement. Each assessment area has 5 levels and corresponding metrics—level 1 represents the most basic provision of care, and level 5 represents optimal care coordination, which may be attainable for some cancer programs and aspirational for others. Progress implies cumulative and sustained fulfillment of lower level criteria. The OCCM can be deployed by cancer programs, regardless of size, setting, resource level, or cancer type. Dissemination to promote wider use is planned through an online benchmarking tool, blogs, a brochure, podcasts, and other resources. Conclusions: The OCCM can be utilized by cancer programs for objective self assessments of care delivery capabilities across 12 high-impact areas. Dissemination can advance multidisciplinary coordinated care delivery and improve clinical outcomes for patients nationwide, regardless of cancer type.

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Abstract Details

Meeting

2020 ASCO Quality Care Symposium

Session Type

Poster Session

Session Title

On-Demand Poster Session: Health Equity and Disparities

Track

Health Care Access, Equity, and Disparities

Sub Track

Access to Treatment and Supportive Care

Citation

J Clin Oncol 38, 2020 (suppl 29; abstr 104)

DOI

10.1200/JCO.2020.38.29_suppl.104

Abstract #

104

Poster Bd #

Online Only

Abstract Disclosures

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