title: Community Oncology Medical Homes: Physician-Driven Change to Improve Patient Care and Reduce Costs.
abstract: Although the patient-centered medical home is a well-established model of care for primary care providers, adoption by specialty providers has been relatively limited. Recently, there has been particular interest in developing specialty medical homes in medical oncology because of practice variation, care fragmentation, and high overall costs of care. In 2012, the Center for Medicare and Medicaid Innovation awarded Innovative Oncology Business Solutions a 3-year grant for their Community Oncology Medical Home (COME HOME) program to implement specialty medical homes in seven oncology practices across the country. We report our early experience and lessons learned.Through September 30, 2014, COME HOME has touched 16,353 unique patients through triage encounters, patient education visits, or application of clinical pathways. We describe the COME HOME model and implementation timeline, profile use of key services, and report patient satisfaction. Using feedback from practice sites, we highlight patient-centered innovations and overall lessons learned.COME HOME incorporates best practices care driven by triage and clinical pathways, team-based care, active disease management, enhanced access and care, as well as financial support for the medical home infrastructure. Information technology plays a central role, supporting both delivery of care and performance monitoring. Volume of service use has grown steadily over time, leveling out in second quarter 2014. The program currently averages 1,265 triage encounters, 440 extended hours visits, and 655 patient education encounters per month.COME HOME offers a patient-centered model of care to improve quality and continuity of care.
authors.affiliation: University of Tennessee Health Science Center, Memphis, TN; Innovative Oncology Business Solutions; New Mexico Oncology Hematology Consultants, Albuquerque, NM; and American Medical Association Board of Trustees, Chicago, IL twaters@uthsc.edu.
authors.forename: Teresa M
authors.initials: TM
authors.lastname: Waters
authors.affiliation: University of Tennessee Health Science Center, Memphis, TN; Innovative Oncology Business Solutions; New Mexico Oncology Hematology Consultants, Albuquerque, NM; and American Medical Association Board of Trustees, Chicago, IL.
authors.forename: Jennifer A
authors.initials: JA
authors.lastname: Webster
authors.affiliation: University of Tennessee Health Science Center, Memphis, TN; Innovative Oncology Business Solutions; New Mexico Oncology Hematology Consultants, Albuquerque, NM; and American Medical Association Board of Trustees, Chicago, IL.
authors.forename: Laura A
authors.initials: LA
authors.lastname: Stevens
authors.affiliation: University of Tennessee Health Science Center, Memphis, TN; Innovative Oncology Business Solutions; New Mexico Oncology Hematology Consultants, Albuquerque, NM; and American Medical Association Board of Trustees, Chicago, IL.
authors.forename: Tao
authors.initials: T
authors.lastname: Li
authors.affiliation: University of Tennessee Health Science Center, Memphis, TN; Innovative Oncology Business Solutions; New Mexico Oncology Hematology Consultants, Albuquerque, NM; and American Medical Association Board of Trustees, Chicago, IL.
authors.forename: Cameron M
authors.initials: CM
authors.lastname: Kaplan
authors.affiliation: University of Tennessee Health Science Center, Memphis, TN; Innovative Oncology Business Solutions; New Mexico Oncology Hematology Consultants, Albuquerque, NM; and American Medical Association Board of Trustees, Chicago, IL.
authors.forename: Ilana
authors.initials: I
authors.lastname: Graetz
authors.affiliation: University of Tennessee Health Science Center, Memphis, TN; Innovative Oncology Business Solutions; New Mexico Oncology Hematology Consultants, Albuquerque, NM; and American Medical Association Board of Trustees, Chicago, IL.
authors.forename: Barbara L
authors.initials: BL
authors.lastname: McAneny
mesh_terms: D000368:Aged; D017046:Cost Savings; D057286:Electronic Health Records; D018588:Fee-for-Service Plans; D005260:Female; D006801:Humans; D008297:Male; D008495:Medical Oncology / Q000191:economics*; D005791:Patient Care / Q000191:economics*; D010348:Patient Care Team; D017060:Patient Satisfaction; D018802:Patient-Centered Care / Q000191:economics*; D010820:Physicians; D011785:Quality Assurance, Health Care; D014218:Triage