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In Honor of
Prostate Cancer Awareness Week and Month
PCEC is pleased to release a
Policy Position on Care Coordination
Care
coordination is an emerging issue in the health landscape that will directly impact
the treatment of prostate cancer, including timely referrals and physician reimbursement,
early detection of disease and the treatment of other prostate conditions.
Too often, primary care doctors do not receive the complete picture when
it comes to their patients' health. This can occur when patients are referred to a specialist (urologist or
oncologist) who makes treatment decisions without informing the primary care
doctor. This leaves the primary
care doctor unaware of new medications or procedures ordered by the
specialist. Because of the "gap"
in communication and care coordination, patients are put in a vulnerable position
that could jeopardize their health.
Additionally, due to the financial incentives built into our current
healthcare system, medical professionals, including urologists, can be
reluctant to refer patients to other specialists, like oncologists. More and more often, urologists are
providing radiation therapy in their own offices or in centers that they own
instead of referring patients with prostate cancer to oncologists, since
Medicare will pay up to $45,000 per patient treated. This type of treatment has increased by nearly 8 percent
each year since 2003 at the expense of other, cheaper treatments like radiation
seed implants and "watchful waiting." As a result, we estimate that about 30 percent of men treated for
prostate cancer receive unnecessary radiation.
Taken together, it is distressing that patients are not always receiving
the most appropriate care available. This is especially relevant for men at risk for prostate conditions as:
- Prostate
condition risk and incidence increases with age, and older patients often
experience co-morbidities that require specialized care (i.e., patients are
likely to be seeing a greater number of providers).
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The first
sign of a prostate condition can often be identified through routine medical
examinations by primary care doctors, but might require specialized care.
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Prostate cancer
often requires multiple caregivers, including a primary care physician or
urologist, as well as an oncologist.
Implementation of the care coordination model will improve practices
between healthcare providers (and between doctors and patients) and will
de-incentivize the predatory practices currently being employed by some
specialists. Ensuring care is
provided in a timely and efficient manner by the right health professional will
help lead to improvements in patient health, enable patients to become active,
informed partners in their healthcare decisions and discourage wasteful
spending in the healthcare system.
Tools to Improve Care Coordination
Recognition of these challenges has given way to a variety of proposals
for change to the healthcare delivery system. In fact, the argument for better care coordination is so
strong that several potential solutions were incorporated into the healthcare
reform legislation enacted into law in March 2010. Below is an overview of mechanisms proposed within the law
that have potential to improve care coordination as it relates to prostate
care. Of note, as the government
and other groups spearhead pilot programs to better understand the full impact
and value of these mechanisms, specifics regarding the definition and
parameters will continue to evolve.
Medical Homes - a
medical office or clinic that assigns a point person and a team of health
professionals to offer personalized, coordinated primary healthcare to each
patient. The medical home is paid
a fee per patient by insurers, which covers the range of services essential to
providing high quality healthcare, including ongoing communication with a
patient's specialist.
Accountable Care Organizations (ACO) -
physician groups and practices can form ACOs wherein participating providers
agree to manage the full range of patient care - from hospital to home to
doctor's offices, including specialist care - for a fixed payment per patient.
Electronic Health Records (EHR) - a way
to capture patient health information - including demographics, medical
history, vital signs, progress notes and laboratory data - in an electronic
format so that is more easily accessed and shared among providers. By providing access to the full
spectrum of medical records, EHR can help providers understand and treat a
patient based on their full medical profile.
PCEC's Position on Care Coordination
PCEC supports initiatives and programs designed to improve care coordination
that are consistent with the following principles:
1.
Care for prostate conditions should be
comprehensive, well-coordinated and accessible to patients when and where they
need it.
2. Specialists, including urologists and oncologists,
should be appropriately incentivized to refer patients to other specialists and
physicians to effectively manage a patient's prostate health.
3. Patients should be partners in their healthcare and
have access to the information they need to manage their prostate health and
make informed treatment decisions.
4. Patients should benefit from the full disclosure of
financial interests that benefit their physicians and should be given the
opportunity to seek treatment at a location of their choice.
Based on these principles, PCEC supports and encourages:
1. Implementation
of both medical home and accountable care organization pilot projects that will
incentivize prostate care providers (i.e., urologists and oncologists) to
provide the appropriate care, including referrals to other health professionals
and ongoing communication with them. PCEC advocates for projects that will explore the
effectiveness of using specialist offices, including urology practices, as the
central medical home or accountable care entity.
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PCEC
supports the provisions for medical home and ACO pilots provided for within the
Patient Protection and Affordable Care Act.
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PCEC
supports adjustments to The Stark Law to eliminate incentives for urologists to
provide radiation treatment without justification.
2. Efforts
to coordinate and integrate care between health providers and cancer patients,
specifically, proposals that would call for cancer survivors to be provided
with a treatment summary and follow-up plan upon completing cancer treatment,
as well as programs to encourage interdisciplinary systems that provide
integrated cancer care.
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PCEC
encourages the adoption of Comprehensive
Cancer Care Improvement Act S.1773/H.R.1844.
3. Oversight
agencies, including the Department of Health and Human Services, to incorporate
prostate condition data collection points into EHR design and
implementation. For example, EHRs
can collect information on annual screening tests, screening test results, and
changes in screening results. Additionally,
PCEC supports efforts to guarantee patients the right to "own" their EHRs and
to access and utilize the data at in the electronic record at their discretion.
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PCEC
supports the implementation of the meaningful EHR initiatives that were
included within the Patient Protection
and Affordable Care Act.
Conclusion
PCEC is encouraged by the developments taking place within the care
coordination landscape. We believe
that implementation of care coordination, as discussed above, has the potential
to make a considerable difference in the lives of men at risk for or living
with various prostate conditions. We look forward to opportunities to support these important mechanisms
as they are put into practice.
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| Prostate
Cancer Awareness Week
September 19-25, 2010
Each day of Prostate Cancer Awareness Week is dedicated to a specific audience with targeted information on an important component of Prostate Health.
The 2010 Days of Prostate Cancer Awareness Week
Monday, Sept. 20 General Prostate Cancer
Tuesday, Sept. 21 Advanced Prostate Cancer
Wednesday, Sept.22 Benign Prostatic Hyperplasia
(BPH)
Thursday, Sept. 23 Women, Families and Caregivers
Day
Friday, Sept. 24 Know Your Numbers Day
Saturday, Sept. 25 On the Horizon Day(Research)
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Screening Site "Tips From Your Peers"
Did you know... |
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PCEC strives to improve our services to
your organization! If you have any
suggestions, or are in need of different educational pieces, please take
this
opportunity to voice your thoughts on our online survey. It only takes a
few moments. Thank you!
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The PACE RACE Series
Welcomes Claudia Curry-Hill to the team
Claudia Curry-Hill, has spent almost three decades of her life actively involved in establishing and spreading the Race for the Cure in the fight against breast
cancer. Her race experience covers the gamut with the first Komen event in Dallas to the series of successful events in Aspen, Colorado, and extensive work with the Race to Erase Multiple Sclerosis. With two grown sons and her
husband's diagnosis of prostate cancer five years ago, she has brought her
extensive knowledge of fund raising, race events and increasing awareness to prostate cancer and our PACE Race series.
"We are excited to add Claudia to our team, her work, success and experience is invaluable. She is the right person to fit our existing team as we the PACE Race series continues to grow and enhance prostate cancer awareness and education," states Wendy Poage, President of PCEC.
Watch for more amazing updates to the PACE Race in upcoming months!
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7009 S. Potomac Street, Suite 125 - Centennial, CO 80112
1-866-4PROST8
www.prostateconditions.org
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Join the Prostate Conditions Education Council on Facebook to keep up to date with current news and events!
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PACE Race Website
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National Council Physicians
| E. David Crawford, M.D.
University of Colorado
David G. McLeod, M.D Walter Reed Army
Mark Moyad, M.D.
University of
Michigan
Allan W. Partin, M.D., Ph.D.
Johns Hopkins
Daniel
Petrylak, M.D.
Columbia-Presbyterian
Mack Roach, M.D.
University
of Calif. SF
Neal Shore, M.D., FACS
Carolina Urologic Research
Center
Frank
Staggers, M.D.
NMA
Nelson
N. Stone, M.D.
Mount Sinai
Wendy Poage, MHA
President, PCEC
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