As the Centers for Medicare & Medicaid Services
(CMS) moves toward a payment system linked to
quality performance, it is important that the oncology
community participates in the ongoing debate
over how to define best quality care and how to
deliver it. In order to shed light on this important
issue, Cancer Care & Economics (CC&E) recently
spoke with Patricia Ganz, MD, professor of health
services and medicine, UCLA School of Public
Health. Dr. Ganz is a member of the board of the
American Society of Clinical Oncology (ASCO) and
co-chair of the Cancer Quality Alliance, a collaboration
between ASCO and the National Coaltion for
Cancer Survivorship (NCCS). The opinions expressed
in the interview are Dr. Ganz's own and not necessarily
those of ASCO.
CC&E: Please describe your work with
the Cancer Quality Alliance.
DR. GANZ: I am co-chairing the Cancer
Quality Alliance with Ellen Stovall,
from the National Coalition for Cancer
Survivorship, and I am representing
ASCO in doing that. The Alliance's priorities
are to develop a template of quality
oncology care and to adopt and test
quality measures. Among other things,
we're also focusing on novel approaches
to coordinate the multidisciplinary aspects
of cancer care.
CC&E: How does the Alliance feel
about the CMS 2006 Demonstration
Project and the pay-for-performance
DR. GANZ: We view the current Demonstration
Project as very favorable. The
pay-per-performance initiative, while it
may seem punitive to some, has great
power to enhance dissemination of the
treatments that we know are effective
within the clinical setting.
Most of the improvements we've seen
in cancer survival have been through the
application of evidence-proven therapies.
But we do not have administrative or
claims data that link us to the clinical
evidence. Current data do not have the
nuanced information about stage and
other fine details that gauge whether the
therapy being applied was the best option.
With the CMS Demonstration
Project, there is an opportunity to harvest
that important information from
physicians in real-time clinical values,
which will help us transition to a system
that rewards performance.
CC&E: How can CMS accurately
evaluate performance in the complex and
constantly evolving world of cancer