In 2016 the Association of Community Cancer Centers (ACCC) launched a three-year initiative to develop an optimal care coordination model (OCCM) to serve lung cancer patients on Medicaid. Funding and support for this project is provided by a grant from the Bristol-Myers Squibb Foundation (BMSF). Phase I of the project began with an environmental scan providing the foundation for the project, identifying the ongoing issues this vulnerable patient population faces. It is critical to focus on improving access and quality of lung cancer services to the Medicaid population given the risks of smoking (the CDC reports that American adults who are uninsured or on Medicaid smoke at rates more than double those of adults with private health insurance or Medicare).
Applications Now Being Accepted
In 2017 the project is entering Phase II. ACCC is recruiting Cancer Program Members* to submit applications to serve as Testing Sites for the OCCM. Testing is necessary to ensure that the OCCM is a practical, easy-to-use guide to help cancer programs improve care for their patients. ACCC’s comprehensive request for applications (RFA) is now available for download. The RFA requires applicants to use the beta OCCM for program self-assessment, and then develop and conduct quality improvement project(s) within the context of the 13 OCCM assessment areas. Testing Sites will receive a stipend.
Phase III, which will consist of testing the OCCM, will take place over a 12-month period, from October 2017-September 2018.
*Under the terms of the grant, programs in the following states are excluded from participation in this project: AL, GA, KY, MS, NC, TN, SC, and WV.
Development of the OCCM
To lay the foundation for development of an optimal care coordination model (OCCM) for lung cancer patients on Medicaid, ACCC completed an environmental scan. The scan included a literature review as well as insights from the project’s Advisory Committee members, a lung cancer survivor and patient advocate, and staff from two ACCC-member cancer programs, which were gathered in a series of interviews conducted in April and May 2016.
Next, through a competitive application process, ACCC recruited Cancer Program Members to serve as project Development Sites — providing real-life experiences illustrating successes and challenges to delivering cancer care to these patients. Each site was visited over a two-day period between August-October 2016, during which ACCC met with a multitude of physicians, staff, patients, and referring providers to obtain their unique perspectives on care delivery across the continuum from initial access through end of life. Read the Development Site reports for snapshots of successes and challenges in providing care to lung cancer patients on Medicaid.
Building on the information gleaned during the research phase, the project’s expert Advisory Committee convened for an in-person meeting in November 2016, for a robust discussion of the project findings and to further inform the development of the OCCM. The model developed for this project builds directly upon the Multidisciplinary Care (MDC) Assessment Tool created by the National Cancer Institute (NCI) Community Cancer Centers Program (NCCCP), a project funded by NCI from 2007-2014. The OCCM is designed to be used for the benefit of cancer programs of all resource levels to improve lung cancer care for patients with Medicaid.
To help guide the Advisory Committee in the development of the OCCM, a Technical Expert Panel was formed, composed of individuals who participated in the NCCCP initiative. The OCCM is not meant to evaluate every aspect of care for a patient with lung cancer, but focuses on 13 areas with high impact on optimal care. Care coordination is assessed from the time of initial patient referral to the cancer program through survivorship and end of life. Each assessment area of the OCCM has 5 levels, with level 1 representing the most basic provision of care and level 5 representing optimal best practice.