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NCCN Guidelines® are Used as Patient Care Model in New UnitedHealthcare Program

By Megan Martin, NCCN Communications Manager

A first-of-its-kind program combining clinical and claims data to assess the quality of a cancer patient’s care is using the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) as the benchmark for the gold standard of patient care. The Oncology Care Analysis (OCA) program recently launched by UnitedHealthcare is comprised of a registry of cancer stage data and claims information that provides a record of the patient’s care and then compares that treatment regimen to the recommendations in the NCCN Guidelines®. Participating oncologists receive aggregate program results in addition to their individual results to provide them with insight to their compliance with the NCCN Guidelines®.

UnitedHealthcare’s senior vice president of oncology, Lee N. Newcomer, MD, stressed the value of the NCCN Guidelines® and utilizing them as a critical piece of the new program, “Treatment of cancer varies widely among doctors and hospitals in the United States. The Oncology Care Analysis program’s goal is to help improve quality and coordination of cancer patient care by providing oncologists with information and feedback relevant to the care they are providing to their patients. Our collaboration with NCCN reflects UnitedHealthcare’s commitment to partner closely with the nation’s leading medical organizations in order to ensure the best care possible for patients,” said Dr. Newcomer.

UnitedHealthcare’s cancer registry includes clinical and claims data from more than 2,600 oncologists and 8,600 patients across the country with breast, colon, or lung cancer. The ensuing OCA electronic medical record not only includes the treatment the patient received, but also delivers coordinated patient information to the treating physicians that may not be contained in their existing medical records, such as patient compliance with medications. For example, physicians may not be aware if their patients are not filling prescriptions for essential cancer medications. The record also contains important information about procedures performed by other specialists, including radiation oncologists and surgeons. 

In late 2009, UnitedHealthcare initially shared OCA program patient data with 1,500 participating oncologists to help them better understand the strengths of their patient care along with areas for improvement. Aggregate national results were shared with 12,000 additional oncologists within UnitedHealthcare’s provider network in an effort to introduce the tool and the cancer registry program.

William T. McGivney, PhD, Chief Executive Officer of NCCN, praised UnitedHealthcare leadership stating, “Programs like the OCA can only enhance the care that patients receive. We applaud UnitedHealthcare for continuing to work with physicians to improve outcomes for patients with cancer.”

Dr. McGivney added, “This latest collaborative effort reflects the continuing commitment of UnitedHeathcare and the NCCN to ensure physicians and patients have access to quality, evidence-based cancer care.”