Aetna (NYSE: AET) is testing out the patient-centered medical home model with cancer patients at an oncology practice in Philadelphia.
Consultants in Medical Oncology and Hematology was the first oncology practice to get recognition from the National Committee for Quality Assurance as a patient-centered medical home. It currently has three offices in the Philadelphia area. Aetna wants to bring its own tools to bear on the group’s model and expand it to other parts of the country.
The idea is to provide a more intimate relationship with the patient and the care delivery team. It would mean better communication, shared decision-making and measuring changes in the quality of care. The oncologist replaces the primary care doctor as taking the lead on care coordination. Aetna’s goal is to standardize this practice to make it easier to implement.
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In response to emailed questions, Dr. Michael Kolodziej, the national medical director for oncology strategies at Aetna, described how it would work in practice.
“The changes we’ve made in the methodology for payment supports this…because we are supporting a patient-centered model vs. transactional model,” he said.
The goal is to make patients so comfortable that no question is too small for them to ask their oncology medical home team, said Kolodziej. That would spur them to use the medical home first, instead of a hospital or ER.
Although Kolodziej said some oncologists have this relationship with their patients, the idea is to standardize it. “The whole package is extremely hard to execute without workflow, process and cultural changes within the practice. We are working to develop the package so that it can be exported to other practices.”
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Asked what he sees as the biggest problems in cancer care, Kolodziej points to fragmented care and that value and quality are not incentivized. He says Aetna’s program is designed to change that.
On the issue of patient engagement, one problem Kolodziej sees is that not enough patients know what their options for treatment are. They also need to be informed, more consistently, about the goals and costs of therapy. There’s also the issue of “end-of-life care.” In response, patients need to have the information and comfort level to raise questions and issues of importance to them.
Another part of the program is big data, specifically eviti’s big data clinical decision support tool for oncology. It identifies the best treatments for particular types of cancer for the best outcomes using information from a digital cancer treatment library. It contains data on 120 cancer types from 1,200 evidence-based treatment regimens and more than 9,000 federally registered clinical trials.
Kolodziej added that eviti also gives it the capability to collect and measure physician performance and outcomes. It fits into a trend in healthcare of applying big data to oncology treatment to identify the best outcomes for various cancer types.
Given the size of the cancer patient population and Aetna’s ability to scale the program, it will be interesting to see how well the program functions on a national level.
