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Oncology Practice Changes During a Multistep Oncology Care Model Practice Transformation Project

Authors: Debra Wujcik, PhD, RN1 ; Susie Owenby, RN1 ; Moh’d Khushman MD2 ; Daniel Cameron, MD2; Thomas Butler, MD2; Cathy Tinnea RN2, Austin Cadden MPH2, Jennifer Pierce, MD2, Sachin Gopalkrishna Pai, MD2
Carevive Systems, Inc, Miami, FL
2 University of South Alabama Mitchell Cancer Institute


  • Treatment of lung cancer has seen a paradigm shift in recent years.
  • While the availability of newer treatment options such as targeted therapy and immunotherapy have provided new hope for better outcomes, this has added to the cost of care.
  • Participation in the Center for Medicare Services’ Oncology Care Model (OCM) provides opportunities for oncology practices to identify practice transformation (PT) change strategies that result in improved quality of care (QOL) and cost savings.


  • A lung cancer practice transformation team convened to facilitate changes that improve patient outcomes and decrease costs at an OCM organization.
  • The year-long project included clinical treatment updates, quantitative and qualitative assessments, and data sharing.
  • Practice changes focused on biomarker-driven treatment selection, nurse navigation to better manage symptoms and decrease emergency department (ED) visits and hospitalizations,
    and earlier advanced care planning (ACP) discussions.
  • Surveys were completed by oncology physicians and nurse practitioners at baseline (n=9) and end of the project (n=7).


Systematic Practice Transformation can improve quality of patients care and measures used in value-based care reimbursement models. Providers need ongoing education, practice feedback, and organizational support to effect positive practice changes. In addition, new strategies to increase provider ability to initiate end of life discussions need to be explored.

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