What Is Practice Transformation? And Why Is It Important?

Practice transformation is a process of change within a healthcare organization, defined by the Centers for Medicare & Medicaid (CMS) as “a process that results in observable and measurable changes to practice behavior.” The aim of these changes is to achieve better health care outcomes, improve communication and trust between patient and provider, and engage in patient-focused and preventative care.  

Practice transformation also urges improved business and financial acumen from healthcare providers, highlighting the need for efficiency and the reduction of unnecessary bureaucracy and wasteful processes. This approach, which combines a focus on evidence-based health outcomes with resource efficiency is also referred to as value-based, or precision care. 

Practice Transformation for Oncology Providers

The oncology sector is currently undergoing a nationwide practice transformation initiative in the form of a transition from OCM (Oncology Care Model) to EOM (Enhancing Oncology Model). The new voluntary model, set to launch on July 1, 2023, is based on “high-value, equitable, evidence-based care” that centers on the patient, aims for better health outcomes, and holds oncology providers accountable for costs. This continues the drive toward value-based care that was also a part of OCM and incorporates the many lessons learned during the previous model’s test period as well as feedback from cancer patients and caregivers.

What Are Common Barriers To a Successful Practice Transformation Program?

Oncology practices seeking to transition to value-based care should be prepared to face certain challenges. Case studies (e.g., from oncology providers in 2014, 2015, and 2020) highlighted issues such as drug prices, lack of resources in time, staff, and money, and administrative confusion when it came to restructuring staff roles and responsibilities. Existing patient portals were also found to be inadequate, lacking tools for patients to report more than basic information. The lack of a clear and standardized structure to follow also delayed  the transition.

How To Address These Challenges

The case studies have so far concluded that, although challenging, the transformations have been beneficial in terms of transitioning to patient-based care and using technology to more efficiently allocate resources. Today’s oncologists can learn from their successes using the following solutions.

• Better practice efficiency and planning
  Healthcare payers are eager to minimize costs and increase efficiency, and providers can more effectively compete when partnered with an experienced organization with a proven track record in improving performance in value-based care that can offer the kind of structure and financial planning that held back providers in the case studies.
• Increased patient engagement
  Healthcare payers are eager to minimize costs and increase efficiency, and providers can more effectively compete when partnered with an experienced organization with a proven track record in improving performance in value-based care that can offer the kind of structure and financial planning that held back providers in the case studies.
• Robust technology tools
  Tools used in the OCM case studies so far include the use of patient portals, electronic health records, apps, webinars, symptom tracking of patients, analytics, regular self-assessments, and audits. Technology  tools mainly facilitated the practice transformation process but were sometimes reported as lacking certain functions or being difficult to integrate with existing symptoms. Choosing an experienced technology  provider that can offer a product catered to your needs could make all the difference. 

Partners To Help Accelerate Your Efforts

To properly implement the transformation to value-based care, clinics are recommended to partner with an organization that has an intimate knowledge of oncology to offer the tools, platforms, and data insights that are specifically relevant to the specialism. 

Sources: 

https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/QualityInitiativesGenInfo
https://www.cms.gov/newsroom/fact-sheets/enhancing-oncology-model
https://www.continuumhealth.net/practice-transformation-using-medical-home-approach/
https://pubmed.ncbi.nlm.nih.gov/26420891/
https://pubmed.ncbi.nlm.nih.gov/32997609/
https://ascopubs.org/doi/10.1200/OP.20.00231
https://www.brookings.edu/articles/case-study-transforming-cancer-care-at-a-community-oncology-practice/
https://www.premierinc.com/newsroom/blog/three-benefits-to-the-oncology-care-model-four-recommendations-to-advance-it
https://ascopubs.org/doi/10.14694/EdBook_AM.2013.33.e361