By William T. McGivney, PhD, Chief Executive Officer
The year, 2010, was indeed an eventful one for NCCN with significant implications for the practice of oncology, particularly with respect to the autonomy of clinicians in making decisions. We started off with a bang as the Affordable Care Act (ACA) was passed. We are ending the year with the expectant arrival of a new U.S. House of Representatives focused on tearing away at some of the significant provisions of the ACA. While Washington, DC was quite busy, there was much activity on the private insurance side with payors focused on reining in technology (e.g, drugs, biologics, devices, techniques) utilization. In the end, the year may be remembered by the positive contributions of the ACA to Patients' rights in terms of coverage for the uninsured, elimination of pre-existing disease exclusions, elimination of lifetime maximums, etc.
The year also will leave a legacy of new acronyms and buzzwords that must be parsed and interpreted (and for some discarded) going forward. Comparative effectiveness (CE), PCORI, IPAB, pathways, episode-based payment, NICE, EHRs, EMRs, ACOs, Medical Home, and a litany of others all have the potential to influence and circumscribe clinician discretion in meeting the needs of patients. The potential for all or some of this to further complicate the Rube Goldberg-like design of the U.S. health care system is real.
The process of comparative effectiveness analysis (CEA) has the greatest potential to impact the availability of drugs, devices, and procedures. Given the rapid advance of science and the resultant proliferation of innovative technologies, formal comparative effectiveness programs are needed and will be helpful to guide clinicians and policy makers. However, such programs must recognize the variation in needs across subpopulations of patients and not unduly and/or unwittingly constrict our ability to meet such needs. Another area of continued emphasis will be the establishment of quality measures and the further integration of these into payment systems. In both areas, it is imperative that the oncology community lead the way in establishing reasonable processes for CEA and for defining quality measures that are truly meaningful to clinicians and to patients.
The NCCN will continue its leadership in serving as a “Voice for Oncology” on behalf of clinicians and patients. In 2011, the NCCN will work to:
The NCCN will maintain its practical view and orientation to information product and program development that facilitates decisions that have to be made in practice and in the policy arena today. As always, we welcome the suggestions of you, our colleagues, regarding the enhancement of existing products and the establishment of new products. Together we will work to fulfill our mission to assure that policies and decision-making in cancer care will meet the needs of the patients whom we serve.
The views and opinions expressed herein are those of the author and not necessarily those of the NCCN.