The Oncology Care Model Patient Experience


It’s no secret that policymakers are working to transform cancer care, shifting the basis of provider compensation from quantity of services to quality of outcomes.

Currently, more than 20% of Medicare fee-for-service payments flow through alternative payment models (APMs), putting the Department of Health and Human Services within reach of their stated goals of 30% by 2016 and 50% by 2018.

One such payment model that will start this summer is the Oncology Care Model (OCM).

Under OCM, cancer centers will be eligible to earn an additional ~$160 per Medicare beneficiary per month, plus shared savings through semi-annual performance based payments. Because many of the OCM requirements and quality measures require changes to current clinic workflow, much attention has been devoted of late to what cancer care centers need to do now to be ready to implement OCM on July 1st.

But at the end of the day, OCM is about patients. So it’s important to understand how this payment model, once implemented, will affect their experience.

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Ready for the Oncology Care Model?

The Oncology Care Model (OCM), set to start later this year, will transform cancer care for patients undergoing chemotherapy.

To many cancer centers, more than a few OCM quality measures will be completely novel.

To provide an easier way for providers to implement OCM successfully, we are pleased to highlight the OCM-specific features and functions of Navigating Care, our comprehensive patient activation and engagement platform:

Navigating Care and the Oncology Care Model

Click here to view this infographic. 
To request a demonstration, contact

Customizing Educational Resources for Cancer Patients


According to Pew Research, 72% of internet users looked online for health information this past year.

This is good because the more patients understand about their particular disease or treatment, the better equipped they are to manage symptoms or side effects. And poor health literacy is an independent risk factor for poor health outcomes, such as unnecessary hospitalizations and decreased treatment compliance.

Cancer patients, facing a life-threatening illness, tend to be especially eager to learn about their disease and therapies. This desire to learn is not easily satiated in the limited time that patients have with their healthcare providers. And visits to the clinic can be stressful. So it’s not surprising that many patients seek information online, where they can process it in a comfortable setting of their choosing.

But consulting Dr. Google is not the best solution.

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Value-Based Payment Models and Why Your EMR May Fall Short


Electronic medical records (EMRs) are the software programs that underlie internal clinic workflow at most health care organizations. They’ve been around for a while but implementation nearly doubled nationwide from 2007 to 2012, thanks to the federal resources poured into EMR adoption as part of the Health Information Technology for Economic and Clinical Health (HITECH) Act of 2009. By the end of 2014, 83% of office-based physicians had adopted an EMR of some sort.

In cancer centers, EMRs are even more prevalent.

Now value in healthcare is shifting from quantity to quality, which means a fresh focus on patient outcomes. And patients that are more engaged in their care have been shown to realize better outcomes. In this new paradigm of increasingly personalized, patient-centered care, patient-facing tools for better care management and engagement are critical.

Again, this trend is particularly true in oncology, with the Oncology Care Model (OCM) poised to launch later this year.

A recent report from the Healthcare Information and Management Systems Society (HIMSS) noted that hospitals typically choose patient-facing software simply because it comes from the same vendor that provides their EMR. That’s like getting your coffee where you get your car tuned-up, or getting your hair done by your gardener.

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Meaningful Use: What to Expect


Last month, acting CMS administrator Andy Slavitt kicked up a media speculation storm when he said,“We are now in the process of ending Meaningful Use and moving to a new regime culminating with the MACRA implementation. The Meaningful Use program as it has existed will now be effectively over and replaced with something better.

It’s true that when the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) begins in earnest, Meaningful Use as a stand-alone program will end. But the EHR requirements on providers, as well as the potential for penalties, will likely remain.

By way of background, the MACRA was passed by the Senate and the House of Representatives last Spring, repealing the Medicare sustainable growth rate (SGR) formula that calculated payment cuts for physicians. The MACRA establishes two options for value-based payment tracks, both set to begin in 2019. These are: the Merit-Based Incentive Payment System (MIPS) or Alternative Payment Models (APMs). The first track consolidates pay-for-performance incentives, rolling up the Physician Quality Reporting System (PQRS), Meaningful Use program and Physician Value-Based Modifier into a composite score and single payment adjustment for physicians. The second track provides bonus payments for physicians with sufficient participation in APMs. These APMs are likely to involve the operation of patient-centered medical homes or accountable care organizations.

As Mr. Slavitt explained in a follow-up blog on January 19th, “While the MACRA continues to require that physicians be measured on their meaningful use of certified EHR technology for purposes of determining their Medicare payments, it provides a significant opportunity to transition the Medicare EHR Incentive Program for physicians towards the reality of where we want to go next.”

Where is that?

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Five Things You Should Know About the Oncology Care Model

Soon, the Center for Medicare and Medicaid Innovation (CMMI) will announce the 100 participants for the Oncology Care Model (OCM), selected from the pool of applications they received last June.

What do all cancer centers need to understand now about how OCM will impact cancer care?

Read our blog in OBR from Navigating Cancer’s CEO Gena Cook here.

Good news for patients, providers and OCM participants: CMS is “dead serious about interoperability”

Last week at the J.P. Morgan Annual Health Care Conference, CMS Acting Administrator Andy Slavitt announced that going forward, rewards for providers will be less about the use of technology and more about the outcomes they achieve with their patients. One way to do this, he explained, is to level the playing field by requiring open APIs (application program interfaces).

“And finally”, Mr. Slavitt added, “we are dead serious about interoperability.”

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Why We Do What We Do

At Navigating Cancer, we’re a team of healthcare and technology veterans committed to helping patients and providers fight cancer better. Many of us have family members who have faced cancer, and a few among us are cancer survivors themselves. A couple times a year, we like to take the opportunity to switch on the employee spotlight and dedicate a blog post to one of our own.

Sam Miller –Software Engineer

What motivates you about working at Navigating Cancer?

Where I worked before, the primary mission was to make more money. That doesn’t resonate with me from a “give back to the world” standpoint.

When I was diagnosed with anaplastic astrocytoma (brain cancer), one of the things I thought was: Have I made the world a better place for anyone? I wanted to give back.

In a lot of ways, my cancer diagnosis was a blessing. It empowered me and brought clarity to my life.

When I was undergoing treatment, it would have been great to have access to a cancer-specific patient portal, where I could get information about my disease and treatments. Some of my doctors didn’t want to tell me how long I have to live. They were worried that I would have a negative perspective. I had to use Google to get the information I wanted.

I was on oral chemotherapy for a year and it was tough. The dosing regimen was really complicated, and managing that on top of my lack of sleep and “chemo-brain” induced fog was challenging. I would have really appreciated an app to help me remember what to take and when.

Also, I feel like I might have been more comfortable if I could have communicated with my doctor on a more regular basis. When I did get to see him, he would suggest ways to manage my symptoms and side effects that helped me to feel better. I would have appreciated a convenient way of getting that information more than just once a month. 

What do you enjoy the most about working at Navigating Cancer?

It’s great to work with smart people that have a mission. Like in any work place, the people are going to define the experience.

Sam with his wife, Angela

Sam with his wife, Angela

Navigating Cancer’s Official Comments on the Merit-based Incentive Payment System (MIPS)

To:        Centers for Medicare & Medicaid Services
Date:    November 17th, 2015
Re:     Comments on the Centers for Medicare Medicaid Services (CMS) Request for Information Regarding Implementation of the Merit-based Incentive Payment System, Promotion of Alternative Payment Models, and Incentive Payments for Participation in Eligible Alternative Payment Models

Navigating Cancer is a HITECH-certified, modular EHR vendor that provides oncology patient portals and care management solutions to over a million cancer and hematology patients and over a thousand healthcare professionals. It is from this experience, and our unique focus on helping patients and healthcare providers fight cancer better, that we offer the following recommendation:

We urge CMS to establish explicit interoperability requirements for all IT products that are eligible for use as part of the Merit-based Incentive Payment System (MIPS) or relevant physician focused payment models (PFPMs).

The Report on Health Information Blocking, submitted to Congress in April of this year, describes how the business models of some entities have incentivized them to exercise control over electronic health information in ways that unreasonably limit its availability and use.

If we expect healthcare providers to meet value-based payment requirements and develop the nationwide benchmarks that will be fundamental to addressing population health, it is critical that we address this issue now, and align payment incentives towards advancing and sustaining a health IT ecosystem with durable interoperability.

In the recently released 10-year Interoperability Roadmap, the Office of the National Coordinator of Health Information IT (ONC) outlines how health IT interoperability will lead to better care and better health by way of explicit standards, and by motivating the use of those standards through appropriate incentives. This should not take 10 years.

The way to move forward now is to enforce explicit requirements for application program interfaces (APIs) in the context of any payment model that is designed to improve the quality of healthcare. With the MACRA, congress is taking a first step by stating that doctors and hospitals that receive EHR bonus payments cannot deliberately block the sharing of information. But these requirements need to center on EHR vendors, not providers.

While the definition of the API should be left to the EHR vendor, we recommend that the following broad requirements be part of the IT certification:

  1. The delivery mechanism of the API should be a RESTful web service.
  2. The API must implement clear error handling.
  3. The API must come with a clear outline of the interface itself – inputs, output and errors.
  4. The API must come with sample code and applications that demonstrate a successful use of the API calls.
  5. The API should come with a support channel – community forum (at minimum) and/or ideally dedicated support staff.

At Navigating Cancer, we have seen information blocking firsthand, as some of our practices were made to invest considerable time and energy into getting their current EHR vendors to allow interoperability with ours. At times, EHR companies have flat out refused to interface with our application, even with signed contracts in place from healthcare professionals. Just as this restricts patients who want to access their electronic health information to the use of suboptimal products today, it impedes practices that want to meet the requirements of new payment models sooner instead of later.

We agree with the American Medical Association and the 111 medical societies that joined together in a letter to Congress on November 2nd, 2015, asking that the Meaningful Use program be recast with a laser-like focus on promoting interoperability and allowing innovation to flourish.”

Implementation of the MIPS poses a major opportunity to transform healthcare delivery to value. Yet to achieve this transformation, physician practices and hospitals need technologies that enable the nationwide sharing of health information, analytics and benchmarks. Explicit interoperability and API requirements for all certifiable IT products will revolutionize product development in healthcare technology, spur innovation and competition among software developers and dramatically improve the patient experience.

Thank you for this opportunity to submit our comments.

Gena Cook
Founder & CEO
Navigating Cancer, Inc.
1200 Post Alley, Seattle, WA
Comment Tracking #: 1jz-8mb5-l7sq

Executive Report: Minimizing Hospitalizations for Cancer Patients

Healthcare costs are at an all-time high. The total annual cost of cancer care in the U.S. is projected to reach $175 billion by 2020, if our current trajectory holds.

As cancer care becomes value-based, providers are faced with the challenge of transforming clinic workflow to meet the requirements of new payment models while at the same time caring for the nation’s growing population of cancer patients. The ability to do this successfully, and in an economically sustainable fashion, will depend on effective care management technology solutions.

Hospitalizations are an especially costly expense for our healthcare system, and carry an emotional toll for cancer patients and their loved ones that cannot be calculated. This executive report gives stakeholders a window into Navigating Cancer’s vision for how to combine the right processes and technology to proactively avoid hospitalizations for cancer patients, and walks readers through the key elements that such a comprehensive software solution will entail.

The report can be downloaded here: Navigating Cancer Report_Minimizing Hospitalizations