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 (P4P) initiative?
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 treatment?