ASCO CEO Dr. Clifford A. Hudis
Dr. Barbara L. McAneny
ASCO COME HOME, which is available across the country, is an expansion of IOBS’s COME HOME program. The program is an oncology-specific, patient-centered medical home that integrates oncology care with symptom management processes to provide patients with enhanced access to evidence-based care, while offering practices a clear path for transitioning to an advanced alternative payment model (APM) under the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA).
ASCO has licensed the COME HOME name from IOBS, as well as the program’s readiness assessment and implementation tools. One set of tools helps practices assess whether or not they are ready to transition to an APM. Other tools help practices actually make the change.
“COME HOME has increased patient satisfaction and improved outcomes by improving care delivery systems and reimbursing practices in a way that accounts for the wide range of services that patients with cancer need,” ASCO CEO Clifford A. Hudis, MD, FACP, FASCO, said. “At ASCO, we are delighted to build on IOBS’s innovative work, which shows that a well-designed alternative payment model can provide the foundation for high-quality cancer care and reduced health care costs.”
Initial COME HOME practices have demonstrated the model’s effectiveness at improving health outcomes, enhancing patient care experiences, and positioning practices for success in an evolving health care delivery environment. Early results from the first seven COME HOME practices show a reduction in 30-day hospital readmission rates (down 11.7%), emergency department visits (down 6.6%), inpatient hospital admissions (down 12.5%), and the overall cost of care (down 7.2%).1
The COME HOME practices, combined, also maintained a high patient satisfaction rate, averaging from 91.3% to 98.1%,1 throughout the COME HOME program grant period.
ASCO COME HOME provides direct support to help practices establish comprehensive and coordinated oncology care that will allow providers to:
- Identify and manage symptoms in real time;
- Improve access to providers through same-day appointments and extended night and weekend hours; and
- Provide disease-management guidance to improve treatment decision making, symptom recognition and assistance with patients’ self-care, pain management, and caregiver support.
This program builds on years-long efforts by ASCO to develop and implement APM that supports high-quality, patient-centered, value-based cancer care. In 2015, ASCO released its Patient-Centered Oncology Payment model, which, similar to the COME HOME approach, bundles payments for oncology and better aligns practice reimbursement with the current realities of today’s cancer care.
“For more than a decade, ASCO has been a thought leader in the shift away from the broken fee-for-service physician reimbursement system,” IOBS Chief Executive Officer and Chief Medical Officer Barbara L. McAneny, MD, FASCO, said. “Combining ASCO’s influence with the real-world data and experience of the COME HOME program is a natural and exciting next step for both organizations.”
COME HOME began in 2012, when the Center for Medicare and Medicaid Innovation awarded IOBS a grant to implement and test an oncology medical home model for newly diagnosed or relapsed Medicare beneficiaries, as well as commercially insured patients, with one of seven common cancer types. ASCO COME HOME launched in January 2017 and is actively helping practices across the country as they make the transition to providing value-based cancer care. For more information, email ClinicalAffairs@asco.org.