In the Spotlight: The Emerging Practice of the 'Oncology Medical Home'
By Richard Scott
August 14, 2012
Are specialty practices the next stop on the medical home express? They very well could be, according to recent announcements from several healthcare organizations.
The medical home is expanding into at least one specialty -- oncology -- as the Centers for Medicare and Medicaid Innovation (CCMI) recently awarded a cancer center in New Mexico with a $19 million grant to research, develop and expand an oncology medical home model in an effort to seize upon the medical home's focus on integrated, patient-centered care.
The recipient of the grant is the New Mexico Cancer Center, led by CEO Dr. Barbara McAneny, which currently operates an "oncology physician-directed medical home" at its headquarters in Albuquerque. The New Mexico Cancer Center provides quality-based support services in house, such as avoiding duplication of care and providing patient education, that mark the medical home model.
"This project will create a group of loosely affiliated practices that will focus on the alignment of the multiple components to ensure quality care," said Dr. McAneny in a statement released by the Community Oncology Alliance (COA), where she is a board member. "I am confident that the better care provided by centralized comprehensive care will not only improve patient quality of life and prolong survival, but will also prove to be the most economical model for cancer care."
Oncology isn't the only specialty that could be a fit for the medical home, according to industry data. A 2010 study from the New England Journal of Medicine
found that some specialty practices in cardiology, pulmonology and endocrinology serve as the main source of primary care. Other specialty areas where the medical home may fit include cardiology, nephrology and psychiatry.A True Trend?
In the face of speculation about other specialties considering an adoption of the medical home model, the CMMI grant for the oncology medical home marks the largest amount of federal grant money devoted to a specialty medical home. This is something that the COA plans to expand upon.
"Dr. McAneny's award will give us a roadmap of this protocol for more beneficial patient care," said Ted Okon, COA executive director. "COA is working with key stakeholders -- patient, providers and payers -- to develop an oncology medical home program as a means for providing better, more economical, community-based cancer care."
Implementation of the oncology medical home begins at New Mexico Cancer Center, and is expected to expand to six other practices within the next six months. There are several elements of the oncology medical home that will impact the Cancer Center, including:
- Expansion of staff and hours of operation.
- Strict use of medical necessity guidelines for hospital inpatient admissions.
- Outpatient discharge policies and procedures.
- Data tracking to compare results with those of control groups.
"By the end of the third year, it is NMCC's goal to have a good understanding of all facets of cancer care costs so they can provide a bundled payment mechanism," reads the NMCC statement.
Through it medical home-based efforts, New Mexico Cancer Center seeks to limit unnecessary and avoidable cost expenditures, such as unneeded emergency department services and unnecessary hospital admissions.