MA19.07 Testing an Optimal Care Coordination Model (OCCM) for Lung Cancer in a Multi-Site Study

273 Background: The Association of Community Cancer Centers (ACCC) created an Optimal Care Coordination Model (OCCM), which provides a comprehensive self-assessment tool designed to orient cancer programs to achieving patient-centered, multidisciplinary care. The OCCM is designed to help cancer programs, regardless of resources, location, or population, improve care for lung cancer patients, especially those on Medicaid. Methods: An environmental scan was conducted in early 2016 with a focus on coordination of care after lung cancer diagnosis to improve experiences and outcomes for Medicaid beneficiaries. Five ACCC Cancer Program Members each hosted 2-day site visits in mid-2016. Interview sessions were conducted to explore effective practices and current care models for patients with lung cancer insured by Medicaid. Key problems in care coordination were identified, as well as local solutions that had been put in place to overcome these barriers. The NCI Community Cancer Centers Program’s (NCCCP) Multidisciplinary Care (MDC) Assessment Tool was the foundational template to create the OCCM. The MDC Tool included 7 assessment areas that were identified as impactful to establishing multidisciplinary care and includes a Level 1-5 evaluation matrix. Results: The beta version of the OCCM was created in early 2017. The number of Assessment Areas was expanded to better capture current care coordination philosophies; (1) Patient Access to Care; (2) Prospective Multidisciplinary Case Planning; (3) Financial, Transportation, and Housing; (4) Management of Comorbid Conditions; (5) Care Coordination; (6) Treatment Team Integration; (7) Electronic Health Records (EHR) and Patient Access to Information; (8) Survivorship Care; (9) Supportive Care; (10) Tobacco Cessation; (11) Clinical Trials; (12) Physician Engagement; (13) Quality Measurement and Improvement. Conclusions: Seven ACCC Cancer Program Members are currently validating the model by each implementing at least one program-specific quality improvement project focused on an Assessment Area over a 12-month time period. All programs are collecting extensive data to determine the extent their program improved within an assessment area. Final results will be available for dissemination in 2019.

Download Full-text

An optimal care coordination model for Medicaid patients with lung cancer: Lessons learned from the beta testing phase of a multisite initiative in the United States.

Journal of Clinical Oncology ◽

10.1200/jco.2020.38.15_suppl.e14010 ◽

2020 ◽

Vol 38 (15_suppl) ◽

pp. e14010-e14010

Author(s):

Matthew Smeltzer ◽

Leigh Boehmer ◽

Amanda Kramar ◽

Thomas Asfeldt ◽

Nicholas Ryan Faris ◽

...

Keyword(s):

Lung Cancer ◽

Access To Care ◽

Care Coordination ◽

Care Delivery ◽

Community Outreach ◽

The United States ◽

Lessons Learned ◽

Optimal Care ◽

Coordination Model ◽

Beta Testing

e14010 Background: Medicaid patients with lung cancer often have less favorable outcomes than non-Medicaid patients, which, given provision of care is typically comparable, may be due to socioeconomic disparities between these populations. In 2016, the Association of Community Cancer Centers (ACCC) embarked on a 3-year initiative to develop and test the Optimal Care Coordination Model (OCCM) to improve care coordination for Medicaid patients with lung cancer. A framework of 13 independent care delivery areas, spanning access to care to survivorship and supportive care, aids cancer programs in identifying barriers to access and use of their care, with a focus on Medicaid patients, and therefore enables optimal care coordination. Methods: Seven community-based healthcare systems in 6 U.S. states were selected as OCCM beta testing sites and then supported by the ACCC via site visits and biweekly calls. Sites self-assessed the quality of their care in selected OCCM areas to identify relevant quality improvement projects and improve understanding of needs specific to Medicaid patients. Results: Total patient enrollment across all sites was 926 (257 Medicaid; 669 non-Medicaid). Each site selected 1–2 priority OCCM areas, including patient access to care, prospective multidisciplinary case planning, or tobacco cessation, for projects. Enhanced collaboration, improved programming (e.g., patient navigation and formation of lung health leadership team), and organic programmatic changes due to the OCCM work were identified as successes. Site-specific challenges included inadequate staffing at project start and lack of centralized data collection and coordination. The importance of lung cancer–dedicated navigation, multidisciplinary conference use for treatment planning, and understanding needs specific to Medicaid patients were key transferable lessons. Examples of institutional support received by sites during the project included opportunities for staff training and leadership commitment from other hospital departments to assist with care delivery improvements. Use of the existing OCCM framework; increased staffing, particularly for lung cancer navigation; and expanded community outreach were identified in the sustainability plans. Conclusions: OCCM beta testing helped sites self-assess care delivery and identify areas for improvement. Ultimately, it was apparent that Medicaid patients need to be treated differently to obtain equity of outcomes with non-Medicaid patients.

Download Full-text

An Optimal Care Coordination Model (OCCM) for Medicaid patients with lung cancer: Finalization of the model and implications for clinical practice in the United States.

Journal of Clinical Oncology ◽

10.1200/jco.2020.38.29_suppl.104 ◽

2020 ◽

Vol 38 (29_suppl) ◽

pp. 104-104

Author(s):

Randall A. Oyer ◽

Christopher S. Lathan ◽

Matthew Smeltzer ◽

Amanda Kramar ◽

Leigh Boehmer ◽

...

Keyword(s):

Lung Cancer ◽

Care Coordination ◽

Care Delivery ◽

Multidisciplinary Treatment ◽

The United States ◽

High Impact ◽

Ease Of Use ◽

Cancer Type ◽

Patient Access ◽

Optimal Care

104 Background: In 2016, the Association of Community Cancer Centers (ACCC) launched a 3-year initiative to design, test, and refine an OCCM for Medicaid patients with lung cancer. The aim was to help cancer programs identify and reduce the barriers experienced by Medicaid patients by strengthening lung cancer care delivery systems. Methods: Phase I included Model development. Phases II and III included selection of 7 community-based cancer programs as testing sites to implement quality improvement projects, utilizing qualitative and quantitative assessments. Beta testing demonstrated the Model’s ability to offer practical guidance on improving care coordination to achievable target levels in high-impact areas such as patient access to care, prospective multidisciplinary case planning, and tobacco cessation. Opportunities were identified to improve care coordination beyond lung cancer to other tumor sites. Refinements for clarity of intent, ease of use, specificity, and uniformity across assessment areas were implemented, based on feedback from testing sites. Members of the Technical Expert Panel and the Advisory Committee, ACCC staff, and consultants revised the Model using consensus decision-making. Results: The final OCCM is composed of 12 inter-related assessment areas: patient entry into lung cancer program; multidisciplinary treatment planning; clinical trials; supportive care; survivorship care; financial, transportation, and housing needs; tobacco education; navigation; treatment team integration; physician engagement; electronic health records and patient access to information; and quality measurement and improvement. Each assessment area has 5 levels and corresponding metrics—level 1 represents the most basic provision of care, and level 5 represents optimal care coordination, which may be attainable for some cancer programs and aspirational for others. Progress implies cumulative and sustained fulfillment of lower level criteria. The OCCM can be deployed by cancer programs, regardless of size, setting, resource level, or cancer type. Dissemination to promote wider use is planned through an online benchmarking tool, blogs, a brochure, podcasts, and other resources. Conclusions: The OCCM can be utilized by cancer programs for objective self assessments of care delivery capabilities across 12 high-impact areas. Dissemination can advance multidisciplinary coordinated care delivery and improve clinical outcomes for patients nationwide, regardless of cancer type.

Download Full-text

Evaluation of an interprofessional care coordination model: Benefits to health professions students and the community served

Nursing Outlook ◽

10.1016/j.outlook.2020.09.007 ◽

2020 ◽

Author(s):

Pamela L. Parsons ◽

Patricia W. Slattum ◽

Carla K. Thomas ◽

Jennifer L. Cheng ◽

Danah Alsane ◽

...

Keyword(s):

Care Coordination ◽

Health Professions ◽

Coordination Model ◽

Interprofessional Care

Download Full-text

Patients’ experience of lung cancer care coordination: a quantitative exploration

Supportive Care in Cancer ◽

10.1007/s00520-018-4338-3 ◽

2018 ◽

Vol 27 (2) ◽

pp. 485-493 ◽

Cited By ~ 4

Author(s):

Gemma K. Collett ◽

Ivana Durcinoska ◽

Nicole M. Rankin ◽

Prunella Blinman ◽

David J. Barnes ◽

...

Keyword(s):

Lung Cancer ◽

Care Coordination ◽

Cancer Care ◽

Patients Experience

Download Full-text

Care coordination as a collaborative element of recovery oriented services for persons with severe mental illness

Australasian Psychiatry ◽

10.1177/10398562211037331 ◽

2021 ◽

pp. 103985622110373

Author(s):

Anton N Isaacs

Keyword(s):

Mental Health ◽

Mental Illness ◽

Severe Mental Illness ◽

Community Service ◽

Care Coordination ◽

Community Services ◽

Intersectoral Collaboration ◽

Coordination Model ◽

Form Part ◽

Multiple Health

Objective: To propose a model where care coordination can form part of recovery oriented care when it is included as a collaborative element of services for persons with severe mental illness. Conclusion: A recovery-oriented service requires more than clinical interventions. It also needs to address social determinants and be individualised or person centred. Multiple health and community services need to be involved. A care coordination model is capable of addressing multiple needs. It gives the client the first and foremost voice. It facilitates intersectoral collaboration, reduces the burden on clinical mental health services and is supported by mental health and community service personnel.

Download Full-text