How my practice is improving patient care and reducing costs

Barbara L. McAneny, MD , Former President

As physicians, our No. 1 priority is always our patients. In my work as an oncologist/hematologist at New Mexico Cancer Center, we have been working on how to serve our patients even better.

We take care of very sick people who simply aren’t able to manage their care in a complicated health care environment, so we set out to be the solution for helping them be as healthy as possible.

We figured out that using an aggressive approach to managing cancer side effects can help minimize emergency room visits and hospitalizations. We manage the overall care for our patients, handle insurance issues, take care of scheduling and more. All we ask the patient to do is show up. And we found that offering same-day appointments and encouraging patients to call us before racing to the emergency room—along with some other changes—reduced overall health care costs.

This new delivery model kept patients out of the hospital and became a way to deliver cost-effective care.

In 2012, I was given an award from the Center for Medicare and Medicaid Innovation (CMMI) to take what we’d done in New Mexico Cancer Center and replicate it in six other practices across the country. We’ve started what we call Community Oncology Medical Homes (COME HOME) to test how oncology private practices can provide better care for patients with cancer at a lower cost. By keeping patients out of the hospital and handling what we can in physician offices, we expect to realize significant cost savings.

Our innovative model includes seven important components:

1.  An ongoing relationship with a personal oncologist to provide first contact and continuous, comprehensive care

2.  Physician-led team-based care, where every member of the team works at the top of their license

3.  Whole-person orientation

4.  Integrated and coordinated care

5.  Evidence-based medicine and performance measures to assure quality and safety

6.  Enhanced access, such as late hours and same-day appointments

7.  Payment to recognize the value-add of a medical home

With this work, we estimate an overall Medicare cost savings of more than $4,000 per patient each year, and we’ll enroll about 8,022 Medicare and 1,530 non-Medicare patients during the three-year project. That’s a total Medicare cost savings of $33.5 million and a net savings of $13.77 million, after budget costs.

I’m proud of the work we’re doing. With this new care delivery model, we’re able to improve health outcomes, enhance patient care and increase cost savings. It’s an example of how physicians need to devise new ways of caring for patients in a rapidly evolving health care system.

We physicians should take the lead on creating and testing these new models. At New Mexico Cancer Center, we didn’t figure out a solution overnight. It took time. But once we realized how our aggressive approach was improving patient care and saving money, we knew it was time to expand the model and see how it might transform the way we care for cancer patients.

The AMA is working to identify care delivery and payment models that best serve physicians and patients through its Professional Satisfaction and Practice Sustainability initiative. We’re also developing practice resources that will help physicians minimize administrative burdens in their current practice models. By embracing effective care delivery and payment models, we can improve patient care, reduce costs and increase professional satisfaction.

This post was made possible by Grant Number ICICMS330969 from the Department of Health and Human Services, Centers for Medicare & Medicaid Services. The contents of this publication are solely the responsibility of the authors and do not necessarily represent the official views of the U.S. Department of Health and Human Services or any of its agencies.