Speaking at National Conference, RCCA CEO Terrill Jordan Highlights Keys to Success of New Medicare Cancer Services Reimbursement Model

As Medicare implements a new cancer-care reimbursement model, it is essential that officials consider oncologists’ clinical and patient-advocacy insights, Regional Cancer Care Associates, LLC (RCCA) President and CEO Terrill Jordan, LLM, JD, said at a national conference.

“You need to have the stakeholders in the room,” when developing the metrics that will shape the Centers for Medicare and Medicaid Services’ (CMS) Oncology Care First (OCF) reimbursement model, Mr. Jordan said at the Sept. 25 Patient-Centered Oncology Care (PCOC) conference.

Mr. Jordan spoke from his perspective as leader of RCCA, one of the nation’s largest networks of oncology specialists, and one of the cancer practices in the country participating in CMS’s first Oncology Care Model (OCM). The OCM seeks to improve all aspects of cancer care for Medicare beneficiaries receiving chemotherapy. More than 175 practices across the country have participated in the 5-year pilot program, which provides practices with monthly payments to fund better care coordination, continuous access to medical records, greater access to same-day appointments, care planning, and survivorship care.

The OCF program, which is intended to be the successor to the OCM and could take effect as soon as early 2021, would entail value-based reimbursement. With this approach, the basis for payment changes from how much physicians and healthcare providers do to how well they achieve key clinical outcomes and provide comprehensive services, preserve or enhance patient quality of life.

RCCA has embraced the value-based approach to care as being in patients’ best interests. At the same time, based on the organization’s experience with the OCM and analysis of its internal quality-assurance data, Mr. Jordan noted that it was critical that CMS provide full transparency as it shifts from that model to the OCF. Further, he stressed that CMS must share in a timely fashion the wealth of data it collects nationally on which treatment strategies and other approaches work best in specific types of cancer and patients. “The opportunity to change behavior depends on timely data” that can inform physicians’ selection of treatments and enable them to engage in shared-decision making with patients, he noted.

The Patient-Centered Oncology Care Conference at which Mr. Jordan spoke is an annual event sponsored by the American Journal of Managed Care. This year’s meeting was conducted virtually due to the COVID-19 pandemic. The theme of the meeting was “The Future of Value-Based Care,” and the panel in which Mr. Jordan participated was titled, “Oncology Care First: Policy and Treatment Implications.” He was joined on the panel by Mariam Alboustani, RPh,; Aaron Lyss, MBA,; and Randall O. Oyer, MD.

Mr. Jordan has been the oncology network’s President and CEO for more than 5 years, prior to that he worked as RCCA’s general counsel. Because of RCCA’s experience and expertise in implementing data-driven treatment strategies and cutting-edge cancer therapies in the community setting, RCCA’s clinical leaders and executives are frequent speakers at national healthcare industry events and medical meetings.

Speaking after the conference, Mr. Jordan noted, “The continued shift to value-based care puts the emphasis squarely on what’s best for the patient, and allows efficient use of resources based on what extensive data shows will be most effective for a particular person and treating his or her cancer. It also provides a foundation for looking at and addressing the full range of a patient’s needs. At RCCA, our commitment to comprehensive care, to incorporating the latest evidence into treatment decisions, and to providing cutting-edge care in a convenient, compassionate setting positions us to offer our patients the benefits of value-based care, and to provide CMS with valuable insights as it rolls out the OCF program.”

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With more than 100 cancer specialists practicing at 20+ care centers throughout New Jersey, Connecticut, Maryland, Pennsylvania, and the Washington, DC area, RCCA provides care to roughly 24,500 new cancer patients and 245,000 established patients each year. RCCA offers those patients immunotherapy, targeted treatment, cell-based therapy, and other cutting-edge treatments and diagnostic modalities, as well as access to clinical trials.