Gaps in health equity can contribute to sub-optimal outcomes

Maximizing the opportunities of achieving the best possible outcomes for cancer patients goes beyond the confines of the clinic. Addressing the needs of patients requires understanding and overcoming challenges related to socioeconomic factors and the environment. These challenges, often referred to as Social Drivers of Health (SDoH), encompass the conditions in the environments where people are born, live, grow, eat, play, and die.

SDoH can significantly impact an individual’s health outcomes and overall quality of life, as well as their access to quality medical care. When patients face obstacles in any of these areas, seeking healthcare or following through with their treatment plans becomes difficult. Therefore, it is crucial to help patients overcome these challenges and remove barriers that hinder their ability to concentrate on their treatment.

By assessing and addressing SDoH, we can enhance patients’ access to care and promote optimal outcomes. This approach not only improves their quality of life but also contributes to a more equitable healthcare system. By focusing on the needs of cancer patients beyond the clinic, we can make a significant impact on their treatment journey and ultimately improve their chances of achieving the best possible outcomes.

Challenges addressing SDoH barriers in community oncology

Addressing SDoH barriers comes with its own set of challenges for community oncology practices. Limited staff, tight budgets, and short appointment times make it difficult to comprehensively screen and connect patients with resources. Additionally, navigating fragmented social service systems and respecting patient privacy can add further complexity. In particular, rural community oncology practices must find innovative solutions to overcome these difficulties, which may be less accessible in rural areas, and ensure that patients receive the support they need to address their SDoH barriers.

Three practices in The US Oncology Network (The Network) – Shenandoah Oncology, Southern Cancer Center, and Willamette Valley Cancer Institute & Research Center – have experienced firsthand the difficulties patients encounter in accessing the resources needed to address SDoH barriers. Navigators had to manually search for social service programs, often finding outdated or inactive options, causing delays in connecting patients with appropriate services and causing frustration. Additionally, the limited availability of programs further hindered the ability to find solutions tailored to each patient’s specific needs.

Despite these hurdles, there’s growing support for integrating SDoH efforts into community oncology practices, with resources being developed to help connect patients with social services in their community. The Network has made it a priority to help patients address SDoH barriers so they can access high quality care, within their community.

Connecting patients to social services with The Network and Findhelp

To address the increasing socioeconomic and environmental challenges faced by cancer patients, The Network has partnered with Findhelp, a platform that assists in navigating social services, community resources, and referrals for patients. This collaboration allows for a more comprehensive level of support, efficiently connecting patients with the necessary assistance they require. By doing so, it promotes optimal outcomes for individuals who are often disadvantaged by various circumstances, thereby bridging the gap in health equity.

The implementation of Findhelp has brought significant improvements to Shenandoah Oncology, Southern Cancer Center, and Willamette Valley Cancer Institute & Research Center in their quest to connect patients with the social services they need. The platform has transformed the referral process, allowing practices to track the availability and activity of programs, ensuring patients are referred to active and relevant services. The ability to filter programs based on eligibility criteria has significantly improved efficiency, eliminating the need for manual searches through irrelevant options. Findhelp has also expanded the range of available programs, empowering navigators to educate patients on how to utilize the platform effectively to find the assistance they require. This has not only increased the accessibility of resources for patients but also enhanced the overall patient experience.

By implementing Findhelp, The Network has successfully addressed the challenges practices faced prior to its adoption. The result is a streamlined referral process, improved patient access to vital resources, and increased efficiency for navigators. From June 2023 to June 2024 practices in The Network referred 3,116 patients to community-based social services. Findhelp has truly made a positive impact on practices in The Network, enabling them to provide comprehensive and effective support to their patients.

“Ensuring health equity is not just a moral imperative, but a crucial step in providing the highest standard of care for all cancer patients. At The Network, we recognize the disparities that exist and are committed to level the playing field to provide equal access to quality care. By partnering with Findhelp, we are empowering practices within The Network to assist their patients in finding the social services they need to navigate their cancer journey with dignity and achieve the best possible outcomes.”

Stuart StaggsVice President, Transformation and Shared Services, The US Oncology Network

“Findhelp has given me the ability to look for a broader scope of social service programs that are available for patients and be able to educate patients on how they can use Findhelp to look for assistance for themselves or others.”

Shannon BrannonPatient Navigator Coordinator, ACS LION, Shenandoah Oncology

“Being a part of The Network and utilizing Findhelp has been a game-changer for our practice in helping our patients overcome social drivers of health barriers. With the support of this collaborative platform, we are able to connect our patients with vital community resources and services they need, addressing the underlying barriers and empowering them to access life-changing treatment.”

Stephanie Andrews, MHA, LBSWSocial Worker, Southern Cancer Center

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The Network’s ongoing commitment to empowering patients through addressing SDoH barriers

The Network is dedicated to making a significant impact in addressing SDoH barriers. With a firm commitment to this cause, The Network aims to increase closed loop referrals, a process in which Findhelp refers a patient to an agency and then follows up to ensure that the referral was completed and that the necessary services were provided, within 30 days post-referral by an impressive 65% during Fiscal Year 2024. This commitment is projected to positively impact over half a million patients, ensuring they receive the necessary support and resources to overcome SDoH barriers.

By actively working towards increasing closed loop referrals, practices in The Network demonstrate their dedication to providing comprehensive care to patients. This commitment will not only improve patient outcomes but also contribute to the overall well-being and quality of life for those facing cancer and SDoH challenges. The Network is proud to take a leading role in addressing SDoH and ensuring that patients receive the holistic support they need throughout their cancer journey.

By The Network’s editorial staff

As cancer care evolves at an increasingly rapid pace, The US Oncology Network stands at the forefront of community oncology, dedicated to advancing care and enhancing patient outcomes. Leading this charge is our new president Devon Dickey Womack, whose appointment marks a significant milestone in our journey towards setting new standards in oncology care. With an unwavering commitment and a visionary approach, she is poised to steer The Network through its next phase of growth and innovation, ensuring that we support practices as they continue to deliver best-in-class care.

With a 14-year tenure with The Network and McKesson, Devon is a familiar face and brings deep expertise and dynamic leadership to her new role. Most recently as the chief operating officer of The Network, she made great strides in ensuring practices have the resources they need to operate efficiently and deliver cost-effective, high-quality patient care. She led the launch of The Network’s “Time to First” strategy to improve patient access. Through this initiative, more than 70% of practices in The Network reduced the time for patients to complete their first consult with their oncologist.

Additionally, Devon continues to pave the way for research expansion with eleven practices in The Network entering into new research agreements with Sarah Cannon Research Institute (SCRI).  We are already exceeding our initial treatment trial accruals goal, starting the fiscal year off strong. Our goal is to ensure that more patients have access to modern cancer therapies and treatment trials. Advancing cancer research to make these therapies a reality for everyone happens in the community setting.

Devon is deeply committed to the development and support of oncology practices and their ability to deliver top-tier care, aiming to support more than 25% of cancer patients across the nation. Under her leadership, The Network is continuing to double down on its focus on patient care models that encompass not only state-of-the-art treatments but also psychological and social support for patients and their families.

As she takes the helm of The Network, Devon is enthusiastic about the potential for transformative change in community oncology. Her vision encompasses a broad spectrum of initiatives aimed at enhancing patient care through technological innovation, precision medicine, operational excellence and practice growth.

“There is much to be optimistic about in the future of community oncology. Our commitment lies in providing cutting-edge care, right in your own backyard,” says Devon. “Together, we will ensure that patients receive world-class treatment, while fostering an environment where practices, physicians and care teams can thrive and make a lasting impact on their communities.”

As we embark on this exciting new chapter under Devon’s leadership, The Network is positioned not only to meet the current demands of oncology care but to anticipate and respond to future challenges. Her strategic vision, coupled with a relentless dedication to excellence, will guide The Network as the leader in community oncology, setting the standard for care, compassion and innovation.

By Marcus Neubauer, MD, Chief Medical Officer

The Network was thrilled to host another installment of our Annual Conference last month in Indianapolis. It’s always hard to top the previous year, but we just may have on the heels of tremendous growth of The Network and the excitement for what we are accomplishing together.

The Annual Conference is our signature event, and we were honored to host leaders from practices in The Network as we came together to hear insights on trends in oncology and network with our peers. I feel more energized than ever after the conclusion of the event and know that many who attended feel the same way. The power of The Network was palpable!

Here are a few of my takeaways from this year’s Annual Conference:

The tenacity and ingenuity of practices in The Network is remarkable

The theme of this year’s conference was “the power of community in action” – and I heard countless examples of how practices in The Network are living this every day. When a challenge is identified with the patient experience or clinic workflows, we work together to develop innovative and enduring solutions.

A great example was one that Jason Hammonds shared in his opening session: an initiative at Texas Oncology to redefine how the practice engages with new and existing patients. It is called “Project Touchpoint” and it is a first-of-its-kind, customized platform that uses AI-generated phone triage to capture incoming calls and solve for the issue on the first call. This has shown to significantly reduce unanswered calls.

Across The Network, the patient experience is at the core of innovation and Devon Womack spoke in her session about the investments we are making in this area. Devon reported on a Network-wide initiative to reduce the time to schedule new cancer patients.

We are making tremendous strides in advancing therapies for patients through research

We recently marked the first full year of our joint venture with Sarah Cannon Research Institute (SCRI), a partnership that is elevating clinical cancer research and advancing therapies available for patients. At the Annual Conference, we heard through a panel presentation that more trials are now available to practices in The Network and time to open a trial is much faster with SCRI.  This leads to more clinical trial opportunities for patients.

In addition, Genospace is helping practices in The Network solve one of the most complex challenges in research – identifying eligible patients. Among Genospace’s many functions is the ability to connect biomarker test results with each practice’s clinical data from their electronic health record. This provides advanced clinical trial matching and we’re already seeing practices realize the results of leveraging this technology. We will continue to see more synergies with SCRI and more benefits to the patient as time progresses.

Our focus on precision medicine is ensuring patients receive the most effective treatment possible

In The Network, we’ve been developing a cutting-edge precision medicine program that supports practices in ordering biomarker tests and the use of targeted therapies. Trends presented at the Annual Conference show that this program is taking off.

The team has focused their efforts in three areas: education, workflow and technology. Spanning these areas is the implementation of a genomic ordering module within iKnowMed℠, our oncology electronic health record, to provide practices with National Comprehensive Cancer Network® (NCCN®) testing alerts at the time of diagnosis and staging. The team is also utilizing Genospace for automated biomarker result integration and is continuing to build out the shared capabilities between our organizations. This work is ensuring more patients are receiving the most effective treatments.

While I’ve shared three takeaways here, we discussed a number of other topics at the Annual Conference, including value-based care, public policy, best practices and more. The expertise and the passion in The Network is unmatched and it’s wonderful to be reminded of our collective power when we come together!

ABOUT THE AUTHOR

Marcus Neubauer, MD
Chief Medical Officer

by Jason Hammonds, president

2022 was a year of tremendous growth for The US Oncology Network – and we’ve kicked off 2023 by announcing that two new practices have joined our organization. As we’re growing, we’re not only welcoming new physicians, providers, and practices, but we’re also expanding capabilities, insights and collaboration in support of our unwavering mission to advance community oncology care and keep independent community oncologists flourishing.

Now more than 2,000 providers strong, The Network continues to provide unparalleled clinical tools, financial security, comprehensive operational support and value-based care expertise, all while allowing physicians to remain independent and provide outstanding care for patients close to home.

I’m incredibly proud of what The Network is accomplishing together. This not only includes growing the business to ensure more patients receive care close to home, but also leading the way in key initiatives such as value-based care, precision medicine and clinical research. Let’s take a look back at our past year.

Strength in numbers

Over 280 providers joined The Network in 2022, making us even better equipped to provide care to more patients. And as we grow, we deepen our collective expertise, expand our network of collaboration, and build upon the breadth of resources that we can provide to practices and the patients they serve.

We also had several practices, including Missouri Cancer Associates, Shenandoah Oncology and Maryland Oncology Hematology, renew their management agreements with The Network.

“Being a part of The US Oncology Network has helped our practice remain strong and deliver comprehensive care to our patients,” shared Dr. George Sotos, president, Maryland Oncology Hematology. “We have benefited from The Network’s extensive operational and clinical solutions, including strategic planning support, revenue cycle optimization and efficient drug management.  We have access to both a wide range of promising novel therapies through the research program, and to the collective knowledge of 2,000 providers in The Network.  These capabilities mean that together, we can provide expert, state of the art cancer care to our patients, in their communities, now and in the future.”

You can read about the ways we have helped our practices succeed here.

Shaping the future of cancer care

Physicians in The Network continue to stand out as thought leaders in the industry and were included in over 250 leading publications such as the Journal of Clinical Oncology, American Society of Clinical Oncology, American Journal of Managed Care, and The Hill, just to name a few.

Many physician across The Network have also taken on leadership roles within the industry, including: Dr. Debra Patt, who was recently elected to serve as the Vice President of the Community Oncology Alliance (COA) and elected to join the American Society of Clinical Oncology (ASCO) Board of Directors; Dr. Moshe Chasky, who was elected to serve on the COA Board of Directors, and Dr. Barry Brooks, who sits on the National Community Oncology Dispensing Association (NCODA) Executive Council. As part of The Network’s power, we give independent physicians a platform to share their insights and expertise to help further advance initiatives for patients and providers.

You’ll find highlights from our news coverage here. Thank you to these experts for sharing their perspectives and shaping the future of cancer care.

New initiatives to enhance the power of The Network

As quickly as healthcare is evolving, we are also continually undertaking new initiatives to ensure The Network is at the forefront of care. This year, we:

• Grew our surgical service line, helping our practices provide comprehensive care for patients along the entirety of their journey
• Completed investments to enhance interoperability capabilities, making provider workflows more efficient and ensuring our practices are even better connected with referring physicians
• Continued to invest in and develop a predicine medicine platform, including ease of ordering comprehensive genomic tests accompanied by clinical decision support tools
• Executed on numerous group purchasing organization (GPO) strategies that led to differentiated value for our practices and expanded medically integrated dispensing (MID) capabilities with projects such as Integrated Rx to reach even more patients
• Had an astounding twenty-five practices apply to the Enhancing Oncology Model (EOM), demonstrating our ongoing commitment to value-based care and improving outcomes
• Delivered industry-leading results in the Oncology Care Model (OCM) as well as in innovative commercial payer programs, like our five-year collaboration with Blue Cross and Blue Shield of Minnesota
• Established a joint venture between US Oncology Research and HCA Healthcare’s Sarah Cannon Research Institute, creating a comprehensive clinical research services organization focused on increasing access to clinical trials and bringing together more than 1,300 physicians who are providing access to clinical trials at more than 250 locations in 26 states across the U.S.

Kicking off 2023 by welcoming two new practices

We’re looking forward to another year of growth in 2023 and have begun the year by announcing that two new practices, Epic Care and Nexus Health, have joined The Network. With the addition of these multidisciplinary practices, we are entering new communities in Santa Fe, New Mexico and California’s East Bay, respectively, and expanding our ability to empower high-quality care in the community.

I can’t wait to see what this year brings as we continue to enhance the power of The Network and support our partner practices in achieving their strategic objectives.

ABOUT THE AUTHOR

Jason Hammonds has served as the President of The US Oncology Network since 2021. He has supported The Network for more than 15 years in a range of leadership roles.

As the largest participant in the Oncology Care Model (OCM), representing over 25% of total physician participation and nearly $250 million in combined savings to Medicare, The US Oncology Network welcomes the release of the Enhancing Oncology Model (EOM).

“While we are continuing to review the details of the EOM, we are pleased The Centers for Medicare & Medicaid Services Innovation Center (also known as “CMMI”) is pursuing a voluntary, physician-driven, oncology-specific model that emphasizes health equity,” said Dr. Marcus Neubauer, chief medical officer, The US Oncology Network. “The development and implementation of the OCM was a very collaborative process between CMMI and the stakeholder community, and we look forward to continuing that collaboration to ensure successful participation in this new model.”

The EOM contains new challenges—in comparison to the OCM, the EOM entails more down-side risk, covers a smaller population, and has a lower monthly enhanced oncology services (MEOS) payment, but it also represents a strong step forward on the path toward value-based care.

Every May, we celebrate Oncology Nursing Month to recognize the critical role oncology nurses play in patient care. Despite the challenges of recent years, nurses have continued to show up for patients with fierce dedication and compassion.  

This year’s theme, “The hands and hearts of hope,” reminds us that nurses are often a source of strength and hope for their patients and loved ones. And oncology nurses give hope to their patients and families while they travel through their cancer journey with a gentle touch before a procedure, a kind word in passing, or by comforting a patient or family member at the end of a journey. Oncology nurses tirelessly lead with expertise and compassion while providing hope and comfort for those facing the unimaginable. 

Nurses have been a sense hope since the dawn of the profession, but in the last two years, they have had to juggle more than ever while caring for patients with cancer and the challenges of the pandemic. Through it all, they continue to make personal sacrifices and preserve for their patients. 

We honor all oncology nurses for their dedication, commitment, and passion for helping those in need. Nurses play a key role in their patients’ cancer journey from explaining a diagnosis, to providing guidance through treatment, celebrating victories, and comforting patients through inconceivable setbacks. Even when faced with the most difficult situations, oncology nurses remain fearlessly committed to provide endless compassion and comfort to patients. 

The Network recognizes the important role nurses play in providing the highest quality patient care in a community setting and we are committed to supporting the professional growth and development of all our nurses and clinical staff. Nurses in The Network have access to clinical education programs, various certification courses,  wellness resources and on-going opportunities for leadership development. 

We thank you and celebrate all nurses of The US Oncology Network and beyond during Oncology Nursing Month, and every other day of the year. Thank you for all you do day in and day out! 

ABOUT THE AUTHOR

Value-based care can drive meaningful improvements in patient care by aligning payment with value. While many payers have value-based care programs, differences in structures and requirements can leave practices with an unbalanced focus on program requirements. Creating a quality and value-based care strategy allows practices to harmonize various programs ensuring high-quality patient care while minimizing practice burden.

 Creating a Quality Strategy

Successful performance in value-based care programs can be defined as improved quality of patient care and outcomes, a reduction in the cost of care for patients, payers, and employers, and the realization of financial benefits tied to performance. Creating an overall quality strategy keeps the practice focused on the key initiatives that can drive performance across programs.

• Build a strategy team that is inclusive and meets the requirements of the value-based program in which you are participating. Practices can no longer count on a single quality lead to manage performance; developing a strategy is a team effort and may include various practice members, as well as a quality committee with clinical and administrative stakeholders.
• Map out the requirements for all value-based care programs. Compare the similarities and differences in the data elements used to measure practice performance. Analyze how the score is calculated, and the methodology used to determine the financial benefit associated with the score.
• Review the current performance for each program, at the practice and individual provider level, to see where improvement is needed.
• Form your strategy by starting with high-level key drivers such as access to care, NCCN guidelines, care coordination, and end of life care, then drill down to the individual requirement and measure for each of the areas to identify specific action items for staff. Keep the patient perspective and care improvement at the forefront as you determine the priorities.

 Physician Engagement and Communicating the Quality Strategy

Once the quality strategy is created, a communication plan should be developed. Engage physicians and practice leaders first, then share the value-based care program overview and high-level details with the quality committee and other relevant practice committees. Share the value-based care program in detail with all providers and staff at each clinic. Team members responsible for change processes or creating new workflows should be engaged and help in communicating the new value-based care program including process, metric collection and monitoring, and ongoing performance. Updates should be shared consistently with the quality committee and sites on a consistent basis.

In addition to having a quality strategy in place, physician engagement is key to value-based care program success. When adding to or altering a physician routine, keep improved patient care and physician engagement at the forefront.  As physicians are challenged with shifting priorities, value-based care leads should keep them engaged rather than overwhelmed.

Practices that form an overall quality strategy and juggle the complexities of multiple programs will improve patient care and realize financial gains.

Learn more about managing value-based care programs here.

ABOUT THE AUTHOR