Spotlight on Health Equity: June 2023

Davey Daniel, MD, on the importance of health equity at OneOncology

“Physicians have a duty to provide accessible and affordable care to diverse patient groups in their communities,” said Davey Daniel, MD, chief medical officer at OneOncology Evidence-based oncology (EBO) during the recent Community Oncology Alliance Community Oncology Conference.

EBO: How does OneOncology deal with health equity in its practices?

Daniel: Community oncology is about health equity. We see every patient that walks through the door. We are committed to…[the] The community in which we live, in which we practice, and…since most of our patients live in our local area, we tend to be far more diverse than…academic institutions – and sometimes even hospital systems. We… have that obligation.

When we talk about health equity, and when I talk to the pharmaceutical industry about health equity, it’s how to achieve health equity in research and care [that] They make the research results available at the practice level in multiple locations, not just in large clinics where they can recruit many people in financially affluent communities. You need to make these studies available where patients are being treated. So for a diverse patient population, it must be…[at] several pages…[in] held in several cities across the country…[in] only a few academic centers.

Samyukta Mullangi, MD, MBA: Cancer care navigation platforms can reduce the operational and financial challenges of VBC systems

Partnering with care navigation platforms like Thyme Care can prove beneficial for oncology practices, particularly smaller or rural clinics, when it comes to managing operational and financial risks associated with the shift from fee-for-service (FFS) to Values-Based Care Systems (VBC), according to Samyukta Mullangi, MD, MBA. Mullangi spoke along Evidence-based oncology (EBO) when she was just completing an oncology fellowship at Memorial Sloan Kettering Cancer Center in New York City, New York, is the new medical director at Thyme Care.

EBO: Can you comment on the operational and financial challenges of moving from FMS to VBC and why it would be beneficial to work with companies like Thyme Care to solve these problems?

Mullangi: Practices are increasingly switching from FFS to VBC for good reason. There’s a lot of tailwind directing them in that direction, [and] Almost all of them are related to the fact that health expenditures are made[ing] is increasingly capturing a larger portion of every dollar spent in this economy.

Nevertheless, the switch to VBC represents a huge operational improvement for the practices. Aside from participating in full payments, entering into risk-sharing agreements with insurers represents a total paradigm shift. Part of the problem is that the practices — and this applies not only to cancer, but certainly to cancer — aren’t equipped with the right ones Technology tools are equipped to ensure the health of the population, and that they also do not have sufficient staff to deal with problems that are systematically revealed through surveys or the like.

Let me elaborate on that [technology] piece first. Oncologists today, regardless of the EMR [electronic medical record] They use couldn’t tell you any basic things [such as] How large is your panel, how many patients are on active treatment, how many patients have had first-line therapy in the metastatic setting. No EMR calculates things systematically [such as] Frailty Scores or Palliative Performance Scales, which may indicate the need for advanced care planning or palliative care [consultations]For example.

When patients are admitted or seen in an emergency [department] At a local hospital, oncologists are often only aware of this if they have a good but informal relationship with that hospital’s case manager, or if the patient or family informs them directly. And that is the state of affairs today; It is very difficult to drive population health without taking a bird’s eye view of the population.

Staffing is just as important. Effective VBC and community health require oncologists to regularly assess how their patients are doing from a symptomatic standpoint, particularly when they are receiving active treatment. You’ve heard of Electronic Patient Records [ePROs]; this is becoming the norm. For example, CMS’ upcoming Enhancing Oncology Model requires practices to have a system in place to collect ePROs from their patients regularly and regularly.

It is also important to identify social determinants of health, as these play a large role in how patients are doing and able to maintain treatment. However, dealing with the problems that these regular assessments can create sometimes requires additional staff. And [although] While larger clinics are able to accommodate and integrate these new responsibilities into their existing staffing structure, it is more difficult for smaller or rural clinics. These new demands can perpetuate health inequalities.

Thyme Care tries to solve both. That’s the way it is [technology] The platform enables intelligent triage of patient acuity. It features an ePROs platform that performs battery assessments of symptoms and obtains information on social determinants of health. And the way the model of care is built is that the capacity of the patient is systematically assessed. All of this is supported by teams of navigators and nurses and overseen by a medical director [all] completely remote and centralized.

The combination of [technology] and the staff who can provide Thyme Care[s] Functions that are too expensive or complex for a clinic to reproduce alone. Honestly there is no need. If there are such solutions on the market, I think practices should work together rather than trying to reinvent the wheel.

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