This document discusses how the patient-centered medical home (PCMH) model can help address challenges in cancer care by achieving the "triple aim" of improving patient experience of care, improving population health, and reducing per capita costs of health care. Several pilot oncology PCMH programs showed early promising results, including reductions in emergency room visits and hospitalizations, improved compliance with treatment guidelines, and estimated cost savings. Metrics used to evaluate the success of these programs included reduced utilization, length of stay, advanced imaging use, and improved patient satisfaction and quality of life. The document argues that patient-centered care improves quality of life and outcomes for cancer patients while also being more cost-effective.

1. Patient Centered Medical Home:
Driving Value in Cancer Care
Presented by:
Cami Leech Florio, FACHE, PCMH CCE
Vice President, Operations
Oncology Resource Networks

2. The Continuum of Cancer Care

3. Challenges in Cancer Care
• Highly complex
• Fragmented
• Expensive
“The complexity of the cancer care system is driven by the biology of cancer itself, the
multiple specialists involved in the delivery of cancer care, as well as a health care
system that is fragmented and often ill prepared to meet the individual needs,
preferences, and values of patients who are anxious, symptomatic, and uncertain…”
SOURCE: INSTITUTE OF MEDICINE, DELIVERING HIGH QUALITY CANCER CARE, 2013

4. Costs of Cancer Care
The National Cancer Institute estimates that costs of cancer care in 2010 were $124.6
billion….in 2020, the costs of cancer care will rise to more than $158 billion.
Milliman notes that oncology patients under active treatment represent only 1% of a
payer’s patients…the care of these patients accounts for approximately 10% of costs
AHRQ’s Medical Expenditure Panel Survey, 2011 indicates that the top 3 most
expensive medical conditions are: Heart conditions, cancer and trauma.

5. How do we achieve the Triple Aim in Cancer Care?
SOURCE: IHI HTTP://WWW.IHI.ORG/ENGAGE/INITIATIVES/TRIPLEAIM/PAGES/DEFAULT.ASPX
MonitorMeasure
Repeat Improve

6. PCMH Definition
“A health care setting that
facilitates partnerships between
individual patients, and their
personal physicians, and when
appropriate, the patient's
family.”1
1 PATIENT CENTERED PRIMARY CARE COLLABORATIVE WWW.PCPCC.NET
Patient
Coordinated
Comprehensive
Safe and High
Quality
Accessible

7. How do we deliver Patient Centered Care?
Address the
unique needs of
the patient
Activate
Care
Teams
Leverage
Technology

8. Oncology PCMH Pilot Programs
Medical Oncology Home Pilot
(2011)
Oncology Patient-Centered
Medical HomeTM
(2010)
Michigan Oncology Medical Home
Demonstration Project
(2012)
Florida Blue Oncology ACOs:
Moffitt Cancer Center
Baptist Health/Advanced Medical Specialties

9. Early Results of Pilot Programs
Oncology Patient-Centered Medical Home in Pennsylvania:
o 68% reduction in ER visits per chemotherapy patient
o 51% reduction in hospitalizations per chemotherapy patient
o Estimated savings of $1 million per doctor per year
Wilshire Oncology Medical Oncology Home Pilot:
o Fewer ER visits and hospitalizations (10% v 30%)
o Fewer end of life hospitalizations
o High compliance with nationally validated measures
Michigan Oncology Medical Home Demonstration Project:
o Fewer ER visits and hospitalizations compared to control group
o Estimated savings of $550 per patient in first year

10. Metrics to Evaluate Success
Common:
o ER visits and Hospitalizations
o Length of stay
o Evidence based guideline compliance
o End of life planning and care
Evolving:
o Patient performance status
o Patient satisfaction
o Advanced imaging utilization
Quality
Value =
Cost

11. Final Thoughts
The current focus on primary care is important and has great potential to impact
future costs of cancer care by improving prevention and early detection.
However, we also need to consider how to positively impact the quality of life,
outcomes and costs of today’s cancer patients and survivors.
Patient-centered care is the right thing to do for the patient, and we believe that the
right care for the patient is also inherently higher quality and more cost effective.
Alone we can do so little, together we can do so much – Helen Keller