Ted Okon: How the Community Oncology Alliance (COA) Is Working to Make a Difference
The Group Room sits down with Ted Okon, Executive Director of the Community Oncology Alliance (COA), at the 2012 COA Annual Meeting. Ted talks about the challenges facing community oncology, where 4 out of 5 cancer patients are current treated and what COA is doing to advocate on their behalf.
The Group Room interviews at the Community Oncology Alliance (COA) 2012 annual meeting in Las Vegas was made possible by the generous support of our members.
Selma Schimmel, Founder & CEO, Vital Options International
This is Selma Schimmel in Las Vegas at the Community Oncology Alliance meeting, and now I have the pleasure of meeting the Executive Director of the Community Oncology Alliance, Ted Okon. And Ted, you’re going to give us an overview. A lot of people don’t know about the important work of the Community Oncology Alliance. I think it’s really important for patients in particular to realize what the majority of us – because I’m also a cancer survivor – treated in the community, the role and scope of responsibilities that the Community practice physician has, and they have to stay on top of so much information as technology changes and new cancer therapies expand. The doctor out there in the community really, really stays on top of tremendous amounts of change that comes at them very rapidly.
Ted Okon, Executive Director, Community Oncology Alliance
That’s right. Well Selma, it’s very unresting because a lot of people don’t realize that actually four out of five Americans that are battling cancer are treated in the Community Oncology setting, and we’ve had a tremendous advance in this country in terms of just last December, we sort of declared our sort of 40th anniversary when we declared the war on cancer. And during that time period there has just been a dramatic evolution in patients, people; Americans who got cancer had to travel great distances usually to an academic setting to be treated, and now they can be treated in their own communities, amongst friends and loved ones, and so it’s a very dramatic transition.
And I’ve had the fortunate to travel the world in terms of going to China, India, far-east, the middle east, the UK, I’m looking at cancer care delivery, and everybody looks back at the United States in terms of this system of quality cancer care that’s also affordable and accessible, and that’s the biggest point – is accessibility to patients.
You’ve also mentioned the distance that patients will sometimes have to travel to an academic center. I think it’s important for patients to know that there are times that – perhaps it’s a clinical trial, or some research protocol – that they can stay in the community, and their doctors can still have a collaborative relationship with a clinical institution or an academic center.
Absolutely, and actually what people don’t realize is there is some tremendous cutting-edge – even what we referred to as phase one experimental research that’s done in the community setting. Some of the very interesting work – your practices like Florida cancer specialist down in Florida, the West Clinic in Memphis, TN that are just doing a lot of cutting-edge research. So the beauty of it now is yes, there are a lot of good care and a lot of cutting-edge research in the academic setting but it’s come to the community setting.
Talk to me a bit about what you feel – there are so many changes happening within our health care delivery system. Let’s talk about the impact that is having within the oncology community settings.
That’s one of the interesting things, and this can get very archane and it’s a topic of discussion in brighter way when I talk about Medicare a lot Americans say ‘well I’m not covered by Medicare , I’m not 65-years yet’ but the fact is with cancer care half of cancer care is covered by Medicare. And the fact is, back in 2003, and 2003 to 2005 time frame, Medicare, which is the 800-pound gorilla in the room in terms of paying for cancer care changed the way that they paid for cancer care. And unfortunately it’s having serious repercussions.
The first repercussion is actually having a consolidation in terms of cancer care delivery, and so you have Doctor Patrick Hobb in Billings, MT who actually has two satellite facilities, or did have two satellite facilities in Wyoming, but he had to close those down because Medicare reimbursement which influences all of private insurance is just unrealistic. So the first shoe to drop that has come, what we often in DC – and I’ve spent a lot of time in Washington DC advocating for cancer care – are unintended consequence of what congress does; and one of those is a consolidation. We’re just on the verge of releasing a report that’s actually going to show clinics closing across the country, clinics that are merging together, and that impacts patients – they fall through the crack.
In your role, how do you see all of this new electronic translation and transmission of patient information ultimately playing out?
I think they’re definitely some benefits. I think if the whole health care reformed debate hopefully impressed among all Americans, they have to be advocates for their own care; they have to be involved in their own care, they have to be knowledgeable. There’s a wealth of information out there and I think we can do a lot better job of bringing electronic communications in terms of coordinating care between the physicians’ office, between the hospital, and having the patient in the loop. The only problem with this is that that has an expense associated with it, and we’re in an environment right now where everything is trying to be cut, and in fact, I’m sure a lot of listeners don’t understand that come the end of this year, if congress doesn’t act there’s going to be a two-percent cut overall for Medicare, which is going to have a dramatic adverse impact on cancer care.
So if you have an environment where we’re trying to control costs, it’s very tough to find the funds to put into the electronic infrastructure. Now, I will tell you that the good thing about it in oncology is you will see that most oncology practices already adapted BMRs, and they’re using that electronic information to the better. And we just had a meeting the other day talking about using texting and interactive information as well too, with patients. So I think we’re at an age where there’s a lot that can be done, there’s a lot that can be done to basically make cancer care a lot better, but the problem is we have to be realistic that some of this new technology – just like a lot of new cancer drugs – costs a lot of money.
What do you need patients to know or to do to help – not only to be proactive but to help – facilitate the necessary changes that have to begin to occur within our health care setting?
Americans have to speak up – again, that’s what we learn from health care reform – they have to speak up, they have to be advocates for themselves, and they have to be advocates for their care. And someone who gets cancer they need to be an advocate, they need to talk to their members of congress; I say that all the time, I spend a lot of time on Capitol Hill talking to members of congress both members in House and the Senate side, and their staff. More patients, more Americans with cancer need to basically talk up. We basically have going on right now the COA Patients Advocacy Network, and they’re meeting and advocates are meeting to talk about getting people more engaged about care.
You know there are a lot of organizations out there that are focused on a cure – and that’s wonderful – either on specific tumor types like breast cancer, or they’re involved overall of looking at the cure. We need a cure, we need to do a better job with prevention; but the problem is we need to advocate for the care as well, too, because right now there are Americans who basically can’t get cared because there’s a drug shortage or all of a sudden their cancer clinic closed and they don’t want to travel that distance. So it’s very important that we have a newer awakening to say ‘let’s advocate for the care as much as we advocate for the cure’.
I think that’s really well-said, and we are now in the spring, the year is evolving ahead. You’ve got a lot on your plate, but your vision right now and your focus of concentration, what do you want us to know about where COA is in the immediate moment?
COA is very actively pushing initiative that we call the Oncology Medical Home. It’s a little different than what you hear about medical homes out there. What it’s meant to do – is unfortunately when someone hears those three terrible little words ‘You have cancer’ – their oncology practices you know becomes virtually their home. And what we’re trying to do is we’re trying to do a next evolution of community cancer care in terms of looking at aspects of quality, looking at aspects of value in terms of cancer care delivery and measuring them, and allow practices to compare themselves to other practices – oncologists compare themselves to other practices, so we lift the boats in terms of making cancer care even more coordinated for the patient, certainly patient-centric, but around the idea that we’re going to measure quality, their satisfaction with their treatment, as well as value measures, too. So we’re putting a push on.
Unfortunately anybody who reads the press knows that with health care reform our system is broken, and unfortunately no matter which side of the isle you sit Medicare is a broken system, and we can’t let policy-makers frame and do what they think they should do in the interest of medicine. The medical professionals need to step up, and that’s why we’ve challenged oncologists around the country, practice administrators as well as pairs of care, insurance companies and most importantly, patients and advocates to come together to say ‘what do we all want from cancer care? Let’s build it into this home medical environment, and lets develop a system; not only for Medicare in terms of payment for cancer care, but with private insurers that’s viable and it is going to work’.
We all have to go about this in collaboration. I think the patients have to be not only more advocates, they have to be collaborative, their physicians have to be collaborative, their nurses have to collaborative, and I think if we’re really going to fix what ails health care in this country first of all it starts with individuals in terms of their own personal health responsibility. There’s a lot of cancer that we can basically not worry about treating if it didn’t first appear because people did a better job of taking care of themselves. But I think once you have a disease like cancer we need to have better communications, more collaboration, and patients who are actively involved in their care.
Ted Okon, Executive Director of the Community Oncology Alliance, you are dynamic and passionate; you are so well-suited to do what you are doing. Thank you very, very much on behalf of cancer patients across the country, and for a great overview of the goals and vision of COA.
Well, I want to thank you. But more importantly, I want to thank every patient out there who’s battling that disease and that those are my real heroes and that’s the real inspiration.
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