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NCCN Holds Third Annual State Oncology Society Forum


The third annual NCCN State Oncology Society Forum, held at the NCCN 19th Annual Conference, examining the evaluation of quality in oncology, the utilization of clinical guidelines and pathways, and the consequences with the Sunshine Act.


FORT WASHINGTON, PA — The National Comprehensive Cancer Network® (NCCN®) held its third annual State Oncology Society Forum during the NCCN 19th Annual Conference: Advancing the Standard of Cancer Care™, facilitating discussions of quality evaluation and implementation, utilization of clinical guidelines and pathways programs, and the intended and unintended consequences of the Physician Payments Sunshine Act.

The Forum commenced with introductions and welcoming remarks from Samuel M. Silver, MD, PhD, Chair, NCCN Board of Directors, and Former President, Michigan Society of Hematology and Oncology (MISHO), following which W. Thomas Purcell, MD, MBA, Associate Director for Clinical Services at the University of Colorado Cancer Center, presented on considerations and key challenges of implementing and evaluating an oncology quality program in today's health care environment.

Dr. Purcell noted that those who succeed in the race to ensure quality will be those who possess high-performing, efficient clinical and research programs, excel in the science of improvement, and have the ability to collaborate across the care continuum. Moreover, he said, quality metrics should be directionally correlated with an improvement in the utilization of the data, and, while a multitude of metrics are possible, choosing the most important ones is key to measuring quality and efficiency.

"Hospitals with 10 centers can have 10 different policies—it is key to standardize the work in order to increase efficiency and, ultimately, quality," said Dr. Purcell.

The Forum continued as Lee N. Newcomer, MD, MHA, Senior Vice President, Oncology, Genetics and Women's Health, UnitedHealthcare, and Michael Kolodziej, MD, FACP, National Medical Director, Oncology Solutions, Aetna, provided an update on utilization of clinical practice guidelines and pathways.

Dr. Newcomer discussed the difference between guidelines and pathways, describing guidelines as documents with the aim of guiding decisions regarding diagnosis, management, and treatment of specific conditions, and pathways as tools used to manage quality in health care using standardization of health care practices. UnitedHealthcare, he said, utilizes the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) in part because the NCCN Guidelines® are transparent, an external source of decisions, a respected authority, and have bias toward patients, not cost. He also noted that timely updates to the NCCN Guidelines further make them a sound choice for the basis of oncology coverage.

Dr. Kolodziej then provided perspective on how clinical pathways help patients, providers, and payers, reviewing Aetna's utilization of commercial pathways and clinical practice guidelines for determination of cancer coverage.

"The principles of our strategy are simple," said Dr. Kolodziej. "Aetna wants to drive efficient use of evidence-based medicine, avoid waste and misuse of medical services, and leverage and integrate the many current and future medical and pharmacy cancer-care initiatives; pathways are an important first step to achieving these goals."

Finally, John Murphy, JD, Assistant General Counsel, Pharmaceutical Research and Manufacturers of America (PhRMA), provided an overview of the evolution of the Sunshine Act as part of the Affordable Care Act. Based upon the belief that the public dissemination of information regarding relationships between industry and physicians will both curb inappropriate activities and aid in government enforcement, the first set of public data is expected to be released by Centers for Medicare and Medicaid Services (CMS) in September. Although originated with good intentions, unintended consequences of the law are emerging that may, in some cases, hamper innovation and collaboration due to lack of clarity around items such as clinical research activities, said Mr. Murphy.

Both CMS and PhRMA offer resources to educate impacted stakeholders. Two mobile applications—Open Payments Mobile for Physicians and Open Payments for Industry—each offer guidance for their respective audience on reviewing and tracking of payments. In tandem, PhRMA has developed Partners for Healthy Dialogues (PFHD), a coalition of health care organizations working to provide information and other resources on implementation of the Sunshine Act—HealthyDialogues.org.

This year's Forum was attended by more than 25 states, representing NCCN's commitment to ongoing collaboration with this important stakeholder group.

"NCCN and state oncology societies share a common goal—to improve the lives of patients with cancer," said C. Lyn Fitzgerald, MJ, Vice President, U.S. and Global Development, NCCN. "We are delighted with our ongoing collaboration toward that effort. This annual meeting, which provides a forum for open dialogue and identification of synergies, is only a part of our year-long information exchange, and we look forward to a continued alliance with these essential stakeholders."

The fourth annual State Oncology Society Forum is planned to be held at the NCCN 20th Annual Conference in March 2015.