Targeting Treatments for Chronic Lymphocytic Leukemia

Dr. Joel Silver

 

How do myeloma and chronic lymphocytic leukemia (CLL) develop? What are some risk factors associated with those malignancies?

A. We don’t know what causes CLL. We do know that people in some occupations or with a certain exposure history might be at higher risk, and that CLL generally affects older people. Treatment fortunately is not needed in many cases, but even so our treatment options have evolved based on cytogenetics and next-generation sequencing. We have more ways to assess prognostic features and design more personalized and potentially more effective therapy for people with CLL.

 

What therapies have been successful in treating CLL over the last two to three years?

A. If you can identify a certain kind of CLL, such as IDH-mutated CLL, some of the patients with it can receive a standard chemotherapy regimen called FCR, and they sometimes go into remission indefinitely. It depends on whether the patient is young and healthy enough to tolerate the therapy. That’s a select group, though; you don’t see too many young people with CLL.

Years ago, an effective treatment did not exist for another group of patients with CLL, those with the genetic 17p deletion. In recent years, however, the oral agent ibrutinib has shown effectiveness for CLL in this group. Other therapies now are available for patients who don’t respond to ibrutinib.

 

Where does targeted therapy come into play?

A. In general, “targeted therapy” refers to a treatment based on a particular mutation or pattern. The presence of the genetic 17p deletion in CLL is one example, but this is a bad cytogenetic abnormality for which standard treatments such as chemotherapy haven’t worked. If we can identify a particular mutation, then we can target our therapy and plan treatment that we know will work, instead of going through chemotherapies that are only partially effective or downright ineffective and then finding that the patient is resistant to treatment.

 

Are there side effects or drawbacks to targeted therapy?

A. Everything we do has side effects. The oral agent ibrutinib has been an effective first-line therapy for any type of CLL. Although the agent is specifically for patients with 17p deletion, it has also worked for patients without that genetic feature. While some cardiovascular and bleeding issues have been reported, ibrutinib overall is more tolerable than chemotherapy.

When we medically examine patients with CLL, we always look at a pattern of mutations to try to identify how to treat these people — not so much from an immediate therapeutic standpoint, but to gain knowledge of all these other cytogenetic abnormalities so that eventually, we will find other ways to target those different patterns.

What important points do you address with patients before they begin CLL therapy?

A. Many people with CLL don’t die of their disease, they die with their disease, so I tell patients not to be afraid of the disease itself. Many of the conversations we have with these people, however, revolve around the fact that they have this problem but may never need treatment. “We should follow you because you may need treatment down the line,” I tell them. “If you need treatment, we have many effective therapies.”

 

Do you foresee different therapies for CLL emerging within the next two to three years?

A. A number of medications are on the horizon that will be appropriate for any patient with CLL. For example, venetoclax, which gained FDA approval last year, is indicated for second-line treatment of CLL in patients with the 17p deletion, but I think that agent will be effective for all patients with CLL. As similarly versatile agents are developed, we will have many more treatment options.

Colorectal Cancer Trends in Maryland: A Conversation with Dr. Ralph V. Boccia

As the third most common cancer in the United States, colorectal cancer (CRC) affects about 1 in 20 Americans. However, incidence and death rates for cancer of the colorectum have significantly decreased over the past several decades as a result of increased screening and drastic improvements in treatment. In Maryland alone, approximately 70% of adults over the age of 50 have an up-to-date colorectal cancer screening, helping contribute to the reduction in mortality rates.

Dr. Ralph V. Boccia, an oncology and hematology specialist at Regional Cancer Care Associates (RCCA) in Bethesda and Germantown, Maryland says, “The more colorectal screening we have and the earlier it gets started, the lower the stage that the cancer is typically picked up.” In turn, early detection has led to the state’s lower mortality rates over time.

 

The Benefits Of Increased Screening

According to Dr. Boccia, improving screening rates “affects the stage at which the cancer presents itself and [the patient’s] potential for survival.” Between 2002 and 2010, the percentage of Maryland adults with up-to-date colorectal cancer screenings increased from 64% to 71%. As a result, CRC mortality rates in Maryland decreased considerably among both men and women in that eight-year timeframe. Dr. Boccia explains, “The trend we’ve actually seen – which is that more people are being screened – has resulted in more improvements of overall survival in patients with colorectal cancer.”

However, as colon cancer rates decline in adults 50 years and older, both incidence and death rates are increasing in the under-50 population. “We’re seeing a scary trend of younger patients getting colorectal cancer,” remarks Dr. Boccia, “even down into the 20s.” However, at this point in time, there’s insufficient data to clearly identify the causation behind this trend.

 

Colorectal Cancer Risk Factors

According to a report from the Maryland Department of Health and Mental Hygiene, the incidence rate of colon cancer per 100,000 people in Maryland was 1,174 for men and 1,109 for women in 2012. When looking at new cases of CRC, research shows that incidence may be tied to habits and lifestyles. Among these lifestyle- associated risk factors are being overweight or obese, lack of physical activity, smoking, heavy alcohol use and certain types of diets.

As outlined by the American Cancer Society, other risk factors unrelated to lifestyle choices are personal and family histories of colorectal cancer or adenomatous polyps, having type 2 diabetes, possessing an inherited syndrome, such as Lynch Syndrome, and certain racial and ethnic backgrounds. In addition, Dr. Boccia notes that a personal history of inflammatory bowel disease may increase the risk for developing colorectal cancer. “Patients with ulcerative colitis have to be screened very frequently for colon cancer,” Dr. Boccia elucidates, “because of that high predisposition.”

 

Common CRC Treatments

“For early stage colorectal cancer, the treatment of choice is surgery,” says Dr. Boccia. In this stage, a group of abnormal cells, referred to as carcinoma in situ (CIS), can be removed by a polypectomy, or a part of the colon can be removed via a partial colectomy. Once the cancer has penetrated the wall of the colon and perhaps even grown into nearby tissue, patients of RCCA Maryland will typically undergo active surveillance – although other treatment options are offered to those with high-risk tumors, says Dr. Boccia.

Once the cancer has reached Stage III, patients are generally offered a form of chemotherapy for roughly six weeks. “FOLFOX is the adjuvant therapy of choice,” says Dr. Boccia, “and that we know will lower the incidence of recurrence by about 40-50%.” For Stage IV diseases, which make up about 20% of the cases that RCCA Maryland sees each year, chemotherapy, targeted therapy and even immunotherapy can be used to offer aggressive treatment. If they no longer respond to a particular drug, patients will be introduced to a new regimen.

In regards to new research and treatment options, Dr. Boccia concludes, “I have 50 to 60 clinical trials open at all times in the center, so we’re always looking actively for good, cutting-edge therapies and offering those to our patients.”

 

If you or someone you love has been diagnosed with colorectal cancer, schedule an appointment at one of RCCA’s 29 locations in New Jersey, Maryland or Connecticut for personalized, professional care.

Molecular Testing: Tailoring Treatment by Targeting Pathways

Phillip D. Reid, MD

 

What is molecular testing? How it is used in cancer care?

A.  As we learn how to treat specific subtypes of cancer more accurately, molecular testing, molecular medicine and molecular diagnostics are becoming more prominent in oncology.

In the past, once a cancer was diagnosed, we determined the organ where it started, how much cancer was in the body and where it was. We have since discovered many pathways through which a cancer develops. We now need to know not only the stage, type and origin of cancer, but also the pathway through which it developed and then target that pathway.

 

How does the pathway concept affect therapy selection?

A.  It enhances our ability to treat the cancer, but we now need extra testing on a patient’s particular cancer cells. The great thing about molecular testing is we get an answer specific for the individual, not just for everyone, for example, with lung cancer. But it does require more time for us to find the pathway. From the patient’s standpoint, diagnosis and stage are obtained, and then sometimes we have to send off the cancer cells for extra testing, which increases the time between diagnosis and treatment. But ultimately, a better sense is provided of what drug to use and when to use it, and there’s a much greater likelihood of devising specific, effective treatment.

 

For which types of cancer should molecular testing be used?

A.  Molecular testing has revolutionized every major cancer diagnosis. Patients with lung and breast cancer are the best candidates, but molecular testing also is useful in colon cancer, head-and-neck and bladder cancer, and some leukemias and myelomas.

 

What have been the main developments over the last two to three years with molecular testing?

A.  It’s becoming easier and more standardized to get molecular testing done. A patient receives a diagnosis and his or her cancer is sent off to a lab, which evaluates all known pathways for that cancer. A specific result is received. As the patient receives therapy, sometimes the cancer changes and he or she may need a second or third biopsy one to three years after the initial diagnosis to see what’s changed in the cancer, and then the treatment changes based on that result. We now see cancer as a moving target as it progresses, and we have to recalibrate every few years so that we’re shooting that target correctly.

 

What should patients know about molecular testing before proceeding?

A.  After a patient receives his or her staging diagnosis, the next question is, “What subtype of lung cancer do I have and what pathway did the cancer use to develop?” The patient needs to have patience, as that extra information may not arrive for two to four weeks, but that information can increase the chances of treatment success.

Also ask about clinical trials of cancer medications before beginning therapy, because we often know about upcoming medications that are effective and possibly better than what we have right now.

Colorectal Cancer Trends and Treatment

Ralph V. Boccia, MD, a cancer specialist at RCCA Maryland, provides some insight into recent colorectal cancer trends and treatments that are giving new hope to doctors, researchers and patients nationwide. Overall, Dr. Boccia finds much to be encouraged by, but also points to the need for awareness of a concerning development in the field of colorectal cancer.

 

How Far We’ve Come and Where We’re Going

As a whole, colorectal cancer rates have been dropping. According to the National Cancer Institute and Centers for Disease Control and Prevention, Maryland alone has seen a 2.6% decrease in the amount of new CRC patients diagnosed over a five-year period. Dr. Boccia believes this trend can be partly attributed to the following:

  • Widespread increase in colonoscopies and other CRC screening methods
  • Early detection and removal of polyps before they become cancerous
  • More cases being diagnosed at an early stage – when the cancer is more responsive to treatment

Despite the good news, it’s still projected that 2,358 Maryland residents will be diagnosed and that 927 people will die from the disease this year, says Dr. Boccia. Doctors have also been noticing an uncharacteristic increase in the amount of younger adults being diagnosed with CRC. Since it typically affects individuals above the age of 50, this emerging demographic has been cause for concern. But Dr. Boccia and his colleagues will continue to conduct research and make further strides in colorectal cancer care to better serve patients of all ages.

 

Current Treatment Options

Surgical innovations, targeted therapies, immunotherapies, chemotherapy and clinical trials are paving the way for more effective CRC solutions. Dr. Boccia explains, “We have a greater ability than ever before to individualize care, and to offer patients multi-modal treatment regimens that employ a variety of mechanisms of action to combat cancer by different means.”

 

Reducing Your Risk

Follow these tips to help reduce your risk for developing colorectal cancer:

  • Maintain a healthy weight
  • Stay physically active
  • Avoid smoking cigarettes and only drink alcohol in moderation
  • Get a CRC screening regularly
  • Consult a physician right away if you experience any CRC symptoms, such as blood in the stool and persistent abdominal pain
  • Manage other conditions that may increase your risk for CRC, like type 2 diabetes, inflammatory bowel disease and adenomatous polyps

 

If you or someone you love has been diagnosed with colorectal cancer, schedule an appointment at one of RCCA’s 29 locations in New Jersey, Maryland or Connecticut for personalized, professional care.

RCCA Earns URAC Accreditation In Specialty Pharmacy

[Hackensack, NJ] – RCCA is proud to announce that it has earned URAC accreditation in Specialty Pharmacy. URAC is the independent leader in promoting healthcare quality through accreditation, certification and measurement. By achieving this status, RCCA has demonstrated a comprehensive commitment to quality care, improved processes and better patient outcomes.

 

“URAC Accreditation is a testament to the commitment of delivering the highest level of quality standards to our patients and their caregivers,” said Terrill Jordan, President and CEO of RCCA. ”This type of commitment is the cornerstone of everything we do at RCCA,” he added.

Edward Licitra, MD, PhD, RCCA Chairperson of the Board and RCCA Pharmacy Medical Director and Eileen Peng, PharmD, Director of the RCCA Pharmacy agree that “this new recognition will allow us to continue to provide the highest level of patient care and convenience for the people that need it the most.”

 

“Pharmacy services have never played such an important role in the delivery of care as they do today. RCCA distinguishes itself for having voluntarily undergone a rigorous review of quality standards that earned it URAC accreditation,” said URAC President and CEO Kylanne Green. “Independent URAC accreditation shows RCCA is dedicated to quality and safety, and that it strives for a continual improvement of its services.”

ABOUT RCCA

Regional Cancer Care Associates (RCCA), one of the largest oncology physician networks in the United States, is transforming oncology care by ensuring that cancer patients have access to the highest-quality, most-comprehensive, cutting edge treatments in a compassionate and community-based setting. RCCA includes more than 100 cancer care specialists and is supported by 800 employees at more than 30 care delivery sites, providing care to more than 24,000 new patients annually and over 240,000 existing patients.  For more information visit: http://www.RCCA.com

About URAC

Founded in 1990, URAC is the independent leader in promoting healthcare quality through accreditation, certification and measurement. URAC is a nonprofit organization developing evidence-based measures and standards through inclusive engagement with a range of stakeholders committed to improving the quality of healthcare. Our portfolio of accreditation and certification programs span the healthcare industry, addressing healthcare management, healthcare operations, health plans, pharmacies, telehealth providers, physician practices, and more. URAC accreditation is a symbol of excellence for organizations to showcase their validated commitment to quality and accountability.

For further information, contact:

Mary Lou Salvemini
msalvemini@regionalcancercare.org
(201) 510-0922

RCCA Makes Innovative UnitedHealthcare Cancer Care Program Available to Patients in Maryland

HACKENSACK, N.J., Nov. 22, 2016 /PRNewswire-USNewswire/ — Regional Cancer Care Associates (RCCA) is expanding its cancer care payment initiative with UnitedHealthcare to RCCA patients in Maryland who are covered by UnitedHealthcare benefit plans.

The program, made available at RCCA New Jersey locations in January, rewards physicians for focusing on best treatment practices, quality patient care and better health outcomes. The program pays participating medical oncologists more if they demonstrate superior clinical results and if they reduce the total cost of care.

The episode payment model shifts reimbursement away from the current “fee-for-service” approach that emphasizes volume of care delivered regardless of a patient’s health outcomes. The episode payment is based on the expected cost of a standard treatment regimen for a specific condition, as predetermined by the doctor. Similar payment models have been shown to enhance care coordination and improve health outcomes for patients, while reducing overall costs.

“RCCA has emerged as a leader in delivering the highest-level quality cancer care to our patients,” said Terrill Jordan, RCCA President and CEO. “New payment methodologies like this put patients’ interests at the forefront of cancer treatment. It also results in significant cost savings, which advances efforts across the country to assist in controlling rising health care costs. We are excited to offer this program to our Maryland patient base.”

Lee N. Newcomer, M.D., UnitedHealthcare’s Senior Vice President, Oncology, said: “Our partnership with RCCA marks an important step toward expanded episode payment models and away from the traditional fee-for-service payments for oncology care. We look forward to working with RCCA and others to expand our efforts to identify best practices for treating cancer.”

A study published in the Journal of Oncology Practice has demonstrated that this program reduced overall cancer expenses by more than a third while improving quality outcomes. RCCA is among five oncology practices that have joined the program, which now has a total of more than 650 oncologists. RCCA in New Jersey and now Maryland comprise approximately 100 of these oncologists.

“Value-based cancer care is here. This program will enable Maryland-based RCCA oncologists to continue to provide patient-centered care at the highest level of quality,” said Ralph Boccia, M.D., RCCA Research Deputy Chair and Oncologist in Bethesda and Germantown, Md.

UnitedHealthcare first implemented its episode payment program as a pilot study between October 2009 and December 2012. The pilot study produced a significant reduction in hospitalizations and a 34 percent reduction in total costs while improving quality. Click here to read results of the study.

About RCCA
Regional Cancer Care Associates (RCCA), one of the largest oncology physician networks in the United States, is transforming oncology care by ensuring that cancer patients have access to the highest-quality, most-comprehensive, cutting edge treatments in a compassionate and community-based setting. RCCA includes 100 cancer care specialists and is supported by 700 employees at 27 care delivery sites, providing care to more than 230,000 existing patients in New Jersey, Maryland and Washington DC.  For more information visit: http://www.RCCA.com

Contact:

Mary Lou Salvemini
msalvemini@regionalcancercare.org
(201) 510-0922

REGIONAL CANCER CARE ASSOCIATES AND AETNA FORM ONCOLOGY MEDICAL HOME

REGIONAL CANCER CARE ASSOCIATES AND AETNA FORM ONCOLOGY MEDICAL HOME

— The Patient-Focused Model Supports High-Value Care–

 

Hackensack, NJ, October 12, 2016 — Regional Cancer Care Associates (RCCA) and Aetna (NYSE: AET) announced a collaboration to create an oncology medical home that is designed to improve the care experience for cancer patients.

In the oncology medical home model, teams of cancer specialists collectively provide a patient’s health care when he or she has a cancer diagnosis. The model will give RCCA the responsibility to arrange appropriate care that is continuous and proactive and physicians will be incentivized for improved health, affordability and a better patient experience.

The oncology medical home arrangement will be available to patients at all RCCA locations in New Jersey and Maryland.

“RCCA is excited to partner with Aetna on this program. It aligns with our vision of providing patient centered care close to home,” said Terrill Jordan, RCCA President & CEO. “This partnership will not only enable us to continue the delivery of high quality care through reduced side effects, but will also facilitate cost effective care based on the data Aetna will be sharing,” said Michael Ruiz de Somocurcio, RCCA Vice President of Payer and Provider Collaboration.

The model is part of a strategic direction to transition from fee-for-service medicine to value-based payment. Value-based arrangements are emerging as a solution to address rising health care costs, clinical inefficiency, duplication of services, and access to care. In value-based models, doctors and hospitals are paid for helping to keep people healthy and for improving the health of those who have chronic conditions in an evidence-based, cost-effective way.

“We understand that cancer treatment can be the hardest experience that our members will ever have to go through,” said Daniel Knecht, M.D., M.B.A., Aetna’s Head of Strategy & Planning and Interim Head of Oncology Solutions. “This oncology medical home with RCCA will help provide our members with high-quality care and an optimal patient experience.”

The operating principles of the RCCA and Aetna oncology medical home include:

  • An orientation to the whole person. A personal physician from RCCA will be responsible for providing or arranging all of a patient’s health care needs with other qualified professionals. This includes care for all stages of treatment: preventive services, acute care, chronic care, palliative care and end-of-life care.
  • Evidence-based, personalized medical care. The RCCA team will focus on making treatment decisions based on current medical evidence for each unique disease presentation, patient-specific factors and patient choice using appropriate treatments to improve quality and outcomes.
  • Coordinated and integrated care. Care will be facilitated, across all elements of the health system, to enable Aetna members to get the appropriate care when and where it is needed and wanted, in a culturally and linguistically appropriate manner.
  • Quality and safety. Quality and safety will be a focus of care, including the use of evidence-based medicine, clinical decision support tools and accountability for continuous quality improvement.
  • Enhanced access to care. Care will be available through systems such as open scheduling, expanded hours and new options for communication between Aetna members, their personal physicians and hospital staff.

The oncology medical home arrangement launched in September 2016.

About RCCA

Regional Cancer Care Associates (RCCA), one of the largest oncology physician networks in the United States, is transforming oncology care by ensuring that cancer patients have access to the highest-quality, most-comprehensive, cutting edge treatments in a compassionate and community-based setting. RCCA includes 100 cancer care specialists and is supported by 700 employees at 27 care delivery sites, providing care to more than 23,000 new patients annually and over 230,000 existing patients in New Jersey, Maryland and Washington DC. For more information visit: http://www.RCCA.com.

About Aetna

Aetna is one of the nation’s leading diversified health care benefits companies, serving an estimated 46.3 million people with information and resources to help them make better informed decisions about their health care. Aetna offers a broad range of traditional, voluntary and consumer-directed health insurance products and related services, including medical, pharmacy, dental, behavioral health, group life and disability plans, and medical management capabilities, Medicaid health care management services, workers’ compensation administrative services and health information technology products and services. Aetna’s customers include employer groups, individuals, college students, part-time and hourly workers, health plans, health care providers, governmental units, government-sponsored plans, labor groups and expatriates. For more information, see www.aetna.com and learn about how Aetna is helping to build a healthier world. @AetnaNews

 

###

What Cancer Patients Need To Know About Clinical Trials: Insights From New Jersey Hematologist /Oncologist Seth Berk

Seth Howard Berk, MD, a hematologist and medical oncologist with RCCA, reveals four facts that he shares with his patients when they ask about clinical trials.

First, a drug has been thoroughly tested well before it reaches the clinical trial stage. Pre-clinical trial testing involves looking at a drug’s effects on animals as well as human cells. This stage usually takes years of development. Also, the clinical studies have to be designed and conducted in accordance with rigorous ethical and safety criteria.

He also imparts the importance of not thinking of clinical trials as a last resort in treatment. While trials are typically suited for situations in which traditional therapy methods are not working for a patient, there is more evidence emerging of late-stage trials benefitting the patient when used early in the diagnosis process.

A myth that Dr. Berk debunks is the use of a placebo in cancer treatment. Some cancer patients are resistant to clinical trials because they fear there will be a placebo and they will suffer as a result. He says this is misinformation or something assumed from a patient’s memory of high school or college science experiments. In clinical trials, one group will be administered the trial agent while the other continues to have traditional therapy. There are rarely ever patients receiving zero care.

Lastly, Dr. Berk addresses the importance of clinical trials for cancer patients in general. Because of willing patients participating in more and more trials, doctors and patients can share in a community of knowledge and understanding, and, one day, a cure.

To read more about clinical trials, turn to “What cancer patients need to know about clinical trials: Insights from New Jersey oncologist/hematologist Seth Berk.”

RCCA: Taking Cancer Care To A Higher Level In NJ And Beyond

Edward J. Licitra, MD, PhD, board certified in internal medicine, hematology and medical oncology and chairman of the board of directors of Regional Cancer Care Associates (RCCA), shares some of his thoughts on potential models for a health care delivery reform system. Oncologists at RCCA, totaling 100 physicians, learn from each other’s best practices with the patient’s interest at the forefront. Through RCCA, patients can receive care at home instead of visiting a hospital or clinic. They have set up 27 care delivery sites, providing care to more than 23,000 new patients annually and approximately 230,000 existing patients in New Jersey, Maryland and Washington, D.C.

Another example of a successful care reform case is the Oncology Care Model (OCM) created by Medicare under the Affordable Care Act (ACA). The model questions how to best develop an integrated style of cancer care. It focuses on developing a care model for the future, using data sharing and streamlining economics for patients as well as providers. By digitizing patients’ medical histories and sharing them through hospitals and clinics, this model focuses on simplifying the oncology care process.

Lastly, the OCM utilizes evidence-based-medicine (EBM) practices throughout the entire spectrum of care. EBM produces the best methods regardless of cost, while even reducing cost by eliminating wasteful spending. The OCM focuses on patient-focused, research based therapy tailored to the individual patient.

To learn more about this topic, read “RCCA: Taking cancer care to a higher level in NJ and beyond.”

Targeting Treatments for Chronic Lymphocytic Leukemia

Dr. Joel Silver

 

How do myeloma and chronic lymphocytic leukemia (CLL) develop? What are some risk factors associated with those malignancies?

A. We don’t know what causes CLL. We do know that people in some occupations or with a certain exposure history might be at higher risk, and that CLL generally affects older people. Treatment fortunately is not needed in many cases, but even so our treatment options have evolved based on cytogenetics and next-generation sequencing. We have more ways to assess prognostic features and design more personalized and potentially more effective therapy for people with CLL.

 

What therapies have been successful in treating CLL over the last two to three years?

A. If you can identify a certain kind of CLL, such as IDH-mutated CLL, some of the patients with it can receive a standard chemotherapy regimen called FCR, and they sometimes go into remission indefinitely. It depends on whether the patient is young and healthy enough to tolerate the therapy. That’s a select group, though; you don’t see too many young people with CLL.

Years ago, an effective treatment did not exist for another group of patients with CLL, those with the genetic 17p deletion. In recent years, however, the oral agent ibrutinib has shown effectiveness for CLL in this group. Other therapies now are available for patients who don’t respond to ibrutinib.

 

Where does targeted therapy come into play?

A. In general, “targeted therapy” refers to a treatment based on a particular mutation or pattern. The presence of the genetic 17p deletion in CLL is one example, but this is a bad cytogenetic abnormality for which standard treatments such as chemotherapy haven’t worked. If we can identify a particular mutation, then we can target our therapy and plan treatment that we know will work, instead of going through chemotherapies that are only partially effective or downright ineffective and then finding that the patient is resistant to treatment.

 

Are there side effects or drawbacks to targeted therapy?

A. Everything we do has side effects. The oral agent ibrutinib has been an effective first-line therapy for any type of CLL. Although the agent is specifically for patients with 17p deletion, it has also worked for patients without that genetic feature. While some cardiovascular and bleeding issues have been reported, ibrutinib overall is more tolerable than chemotherapy.

When we medically examine patients with CLL, we always look at a pattern of mutations to try to identify how to treat these people — not so much from an immediate therapeutic standpoint, but to gain knowledge of all these other cytogenetic abnormalities so that eventually, we will find other ways to target those different patterns.

What important points do you address with patients before they begin CLL therapy?

A. Many people with CLL don’t die of their disease, they die with their disease, so I tell patients not to be afraid of the disease itself. Many of the conversations we have with these people, however, revolve around the fact that they have this problem but may never need treatment. “We should follow you because you may need treatment down the line,” I tell them. “If you need treatment, we have many effective therapies.”

 

Do you foresee different therapies for CLL emerging within the next two to three years?

A. A number of medications are on the horizon that will be appropriate for any patient with CLL. For example, venetoclax, which gained FDA approval last year, is indicated for second-line treatment of CLL in patients with the 17p deletion, but I think that agent will be effective for all patients with CLL. As similarly versatile agents are developed, we will have many more treatment options.

Colorectal Cancer Trends in Maryland: A Conversation with Dr. Ralph V. Boccia

As the third most common cancer in the United States, colorectal cancer (CRC) affects about 1 in 20 Americans. However, incidence and death rates for cancer of the colorectum have significantly decreased over the past several decades as a result of increased screening and drastic improvements in treatment. In Maryland alone, approximately 70% of adults over the age of 50 have an up-to-date colorectal cancer screening, helping contribute to the reduction in mortality rates.

Dr. Ralph V. Boccia, an oncology and hematology specialist at Regional Cancer Care Associates (RCCA) in Bethesda and Germantown, Maryland says, “The more colorectal screening we have and the earlier it gets started, the lower the stage that the cancer is typically picked up.” In turn, early detection has led to the state’s lower mortality rates over time.

 

The Benefits Of Increased Screening

According to Dr. Boccia, improving screening rates “affects the stage at which the cancer presents itself and [the patient’s] potential for survival.” Between 2002 and 2010, the percentage of Maryland adults with up-to-date colorectal cancer screenings increased from 64% to 71%. As a result, CRC mortality rates in Maryland decreased considerably among both men and women in that eight-year timeframe. Dr. Boccia explains, “The trend we’ve actually seen – which is that more people are being screened – has resulted in more improvements of overall survival in patients with colorectal cancer.”

However, as colon cancer rates decline in adults 50 years and older, both incidence and death rates are increasing in the under-50 population. “We’re seeing a scary trend of younger patients getting colorectal cancer,” remarks Dr. Boccia, “even down into the 20s.” However, at this point in time, there’s insufficient data to clearly identify the causation behind this trend.

 

Colorectal Cancer Risk Factors

According to a report from the Maryland Department of Health and Mental Hygiene, the incidence rate of colon cancer per 100,000 people in Maryland was 1,174 for men and 1,109 for women in 2012. When looking at new cases of CRC, research shows that incidence may be tied to habits and lifestyles. Among these lifestyle- associated risk factors are being overweight or obese, lack of physical activity, smoking, heavy alcohol use and certain types of diets.

As outlined by the American Cancer Society, other risk factors unrelated to lifestyle choices are personal and family histories of colorectal cancer or adenomatous polyps, having type 2 diabetes, possessing an inherited syndrome, such as Lynch Syndrome, and certain racial and ethnic backgrounds. In addition, Dr. Boccia notes that a personal history of inflammatory bowel disease may increase the risk for developing colorectal cancer. “Patients with ulcerative colitis have to be screened very frequently for colon cancer,” Dr. Boccia elucidates, “because of that high predisposition.”

 

Common CRC Treatments

“For early stage colorectal cancer, the treatment of choice is surgery,” says Dr. Boccia. In this stage, a group of abnormal cells, referred to as carcinoma in situ (CIS), can be removed by a polypectomy, or a part of the colon can be removed via a partial colectomy. Once the cancer has penetrated the wall of the colon and perhaps even grown into nearby tissue, patients of RCCA Maryland will typically undergo active surveillance – although other treatment options are offered to those with high-risk tumors, says Dr. Boccia.

Once the cancer has reached Stage III, patients are generally offered a form of chemotherapy for roughly six weeks. “FOLFOX is the adjuvant therapy of choice,” says Dr. Boccia, “and that we know will lower the incidence of recurrence by about 40-50%.” For Stage IV diseases, which make up about 20% of the cases that RCCA Maryland sees each year, chemotherapy, targeted therapy and even immunotherapy can be used to offer aggressive treatment. If they no longer respond to a particular drug, patients will be introduced to a new regimen.

In regards to new research and treatment options, Dr. Boccia concludes, “I have 50 to 60 clinical trials open at all times in the center, so we’re always looking actively for good, cutting-edge therapies and offering those to our patients.”

 

If you or someone you love has been diagnosed with colorectal cancer, schedule an appointment at one of RCCA’s 29 locations in New Jersey, Maryland or Connecticut for personalized, professional care.

Molecular Testing: Tailoring Treatment by Targeting Pathways

Phillip D. Reid, MD

 

What is molecular testing? How it is used in cancer care?

A.  As we learn how to treat specific subtypes of cancer more accurately, molecular testing, molecular medicine and molecular diagnostics are becoming more prominent in oncology.

In the past, once a cancer was diagnosed, we determined the organ where it started, how much cancer was in the body and where it was. We have since discovered many pathways through which a cancer develops. We now need to know not only the stage, type and origin of cancer, but also the pathway through which it developed and then target that pathway.

 

How does the pathway concept affect therapy selection?

A.  It enhances our ability to treat the cancer, but we now need extra testing on a patient’s particular cancer cells. The great thing about molecular testing is we get an answer specific for the individual, not just for everyone, for example, with lung cancer. But it does require more time for us to find the pathway. From the patient’s standpoint, diagnosis and stage are obtained, and then sometimes we have to send off the cancer cells for extra testing, which increases the time between diagnosis and treatment. But ultimately, a better sense is provided of what drug to use and when to use it, and there’s a much greater likelihood of devising specific, effective treatment.

 

For which types of cancer should molecular testing be used?

A.  Molecular testing has revolutionized every major cancer diagnosis. Patients with lung and breast cancer are the best candidates, but molecular testing also is useful in colon cancer, head-and-neck and bladder cancer, and some leukemias and myelomas.

 

What have been the main developments over the last two to three years with molecular testing?

A.  It’s becoming easier and more standardized to get molecular testing done. A patient receives a diagnosis and his or her cancer is sent off to a lab, which evaluates all known pathways for that cancer. A specific result is received. As the patient receives therapy, sometimes the cancer changes and he or she may need a second or third biopsy one to three years after the initial diagnosis to see what’s changed in the cancer, and then the treatment changes based on that result. We now see cancer as a moving target as it progresses, and we have to recalibrate every few years so that we’re shooting that target correctly.

 

What should patients know about molecular testing before proceeding?

A.  After a patient receives his or her staging diagnosis, the next question is, “What subtype of lung cancer do I have and what pathway did the cancer use to develop?” The patient needs to have patience, as that extra information may not arrive for two to four weeks, but that information can increase the chances of treatment success.

Also ask about clinical trials of cancer medications before beginning therapy, because we often know about upcoming medications that are effective and possibly better than what we have right now.

Colorectal Cancer Trends and Treatment

Ralph V. Boccia, MD, a cancer specialist at RCCA Maryland, provides some insight into recent colorectal cancer trends and treatments that are giving new hope to doctors, researchers and patients nationwide. Overall, Dr. Boccia finds much to be encouraged by, but also points to the need for awareness of a concerning development in the field of colorectal cancer.

 

How Far We’ve Come and Where We’re Going

As a whole, colorectal cancer rates have been dropping. According to the National Cancer Institute and Centers for Disease Control and Prevention, Maryland alone has seen a 2.6% decrease in the amount of new CRC patients diagnosed over a five-year period. Dr. Boccia believes this trend can be partly attributed to the following:

  • Widespread increase in colonoscopies and other CRC screening methods
  • Early detection and removal of polyps before they become cancerous
  • More cases being diagnosed at an early stage – when the cancer is more responsive to treatment

Despite the good news, it’s still projected that 2,358 Maryland residents will be diagnosed and that 927 people will die from the disease this year, says Dr. Boccia. Doctors have also been noticing an uncharacteristic increase in the amount of younger adults being diagnosed with CRC. Since it typically affects individuals above the age of 50, this emerging demographic has been cause for concern. But Dr. Boccia and his colleagues will continue to conduct research and make further strides in colorectal cancer care to better serve patients of all ages.

 

Current Treatment Options

Surgical innovations, targeted therapies, immunotherapies, chemotherapy and clinical trials are paving the way for more effective CRC solutions. Dr. Boccia explains, “We have a greater ability than ever before to individualize care, and to offer patients multi-modal treatment regimens that employ a variety of mechanisms of action to combat cancer by different means.”

 

Reducing Your Risk

Follow these tips to help reduce your risk for developing colorectal cancer:

  • Maintain a healthy weight
  • Stay physically active
  • Avoid smoking cigarettes and only drink alcohol in moderation
  • Get a CRC screening regularly
  • Consult a physician right away if you experience any CRC symptoms, such as blood in the stool and persistent abdominal pain
  • Manage other conditions that may increase your risk for CRC, like type 2 diabetes, inflammatory bowel disease and adenomatous polyps

 

If you or someone you love has been diagnosed with colorectal cancer, schedule an appointment at one of RCCA’s 29 locations in New Jersey, Maryland or Connecticut for personalized, professional care.

RCCA Earns URAC Accreditation In Specialty Pharmacy

[Hackensack, NJ] – RCCA is proud to announce that it has earned URAC accreditation in Specialty Pharmacy. URAC is the independent leader in promoting healthcare quality through accreditation, certification and measurement. By achieving this status, RCCA has demonstrated a comprehensive commitment to quality care, improved processes and better patient outcomes.

 

“URAC Accreditation is a testament to the commitment of delivering the highest level of quality standards to our patients and their caregivers,” said Terrill Jordan, President and CEO of RCCA. ”This type of commitment is the cornerstone of everything we do at RCCA,” he added.

Edward Licitra, MD, PhD, RCCA Chairperson of the Board and RCCA Pharmacy Medical Director and Eileen Peng, PharmD, Director of the RCCA Pharmacy agree that “this new recognition will allow us to continue to provide the highest level of patient care and convenience for the people that need it the most.”

 

“Pharmacy services have never played such an important role in the delivery of care as they do today. RCCA distinguishes itself for having voluntarily undergone a rigorous review of quality standards that earned it URAC accreditation,” said URAC President and CEO Kylanne Green. “Independent URAC accreditation shows RCCA is dedicated to quality and safety, and that it strives for a continual improvement of its services.”

ABOUT RCCA

Regional Cancer Care Associates (RCCA), one of the largest oncology physician networks in the United States, is transforming oncology care by ensuring that cancer patients have access to the highest-quality, most-comprehensive, cutting edge treatments in a compassionate and community-based setting. RCCA includes more than 100 cancer care specialists and is supported by 800 employees at more than 30 care delivery sites, providing care to more than 24,000 new patients annually and over 240,000 existing patients.  For more information visit: http://www.RCCA.com

About URAC

Founded in 1990, URAC is the independent leader in promoting healthcare quality through accreditation, certification and measurement. URAC is a nonprofit organization developing evidence-based measures and standards through inclusive engagement with a range of stakeholders committed to improving the quality of healthcare. Our portfolio of accreditation and certification programs span the healthcare industry, addressing healthcare management, healthcare operations, health plans, pharmacies, telehealth providers, physician practices, and more. URAC accreditation is a symbol of excellence for organizations to showcase their validated commitment to quality and accountability.

For further information, contact:

Mary Lou Salvemini
msalvemini@regionalcancercare.org
(201) 510-0922

RCCA Makes Innovative UnitedHealthcare Cancer Care Program Available to Patients in Maryland

HACKENSACK, N.J., Nov. 22, 2016 /PRNewswire-USNewswire/ — Regional Cancer Care Associates (RCCA) is expanding its cancer care payment initiative with UnitedHealthcare to RCCA patients in Maryland who are covered by UnitedHealthcare benefit plans.

The program, made available at RCCA New Jersey locations in January, rewards physicians for focusing on best treatment practices, quality patient care and better health outcomes. The program pays participating medical oncologists more if they demonstrate superior clinical results and if they reduce the total cost of care.

The episode payment model shifts reimbursement away from the current “fee-for-service” approach that emphasizes volume of care delivered regardless of a patient’s health outcomes. The episode payment is based on the expected cost of a standard treatment regimen for a specific condition, as predetermined by the doctor. Similar payment models have been shown to enhance care coordination and improve health outcomes for patients, while reducing overall costs.

“RCCA has emerged as a leader in delivering the highest-level quality cancer care to our patients,” said Terrill Jordan, RCCA President and CEO. “New payment methodologies like this put patients’ interests at the forefront of cancer treatment. It also results in significant cost savings, which advances efforts across the country to assist in controlling rising health care costs. We are excited to offer this program to our Maryland patient base.”

Lee N. Newcomer, M.D., UnitedHealthcare’s Senior Vice President, Oncology, said: “Our partnership with RCCA marks an important step toward expanded episode payment models and away from the traditional fee-for-service payments for oncology care. We look forward to working with RCCA and others to expand our efforts to identify best practices for treating cancer.”

A study published in the Journal of Oncology Practice has demonstrated that this program reduced overall cancer expenses by more than a third while improving quality outcomes. RCCA is among five oncology practices that have joined the program, which now has a total of more than 650 oncologists. RCCA in New Jersey and now Maryland comprise approximately 100 of these oncologists.

“Value-based cancer care is here. This program will enable Maryland-based RCCA oncologists to continue to provide patient-centered care at the highest level of quality,” said Ralph Boccia, M.D., RCCA Research Deputy Chair and Oncologist in Bethesda and Germantown, Md.

UnitedHealthcare first implemented its episode payment program as a pilot study between October 2009 and December 2012. The pilot study produced a significant reduction in hospitalizations and a 34 percent reduction in total costs while improving quality. Click here to read results of the study.

About RCCA
Regional Cancer Care Associates (RCCA), one of the largest oncology physician networks in the United States, is transforming oncology care by ensuring that cancer patients have access to the highest-quality, most-comprehensive, cutting edge treatments in a compassionate and community-based setting. RCCA includes 100 cancer care specialists and is supported by 700 employees at 27 care delivery sites, providing care to more than 230,000 existing patients in New Jersey, Maryland and Washington DC.  For more information visit: http://www.RCCA.com

Contact:

Mary Lou Salvemini
msalvemini@regionalcancercare.org
(201) 510-0922

REGIONAL CANCER CARE ASSOCIATES AND AETNA FORM ONCOLOGY MEDICAL HOME

REGIONAL CANCER CARE ASSOCIATES AND AETNA FORM ONCOLOGY MEDICAL HOME

— The Patient-Focused Model Supports High-Value Care–

 

Hackensack, NJ, October 12, 2016 — Regional Cancer Care Associates (RCCA) and Aetna (NYSE: AET) announced a collaboration to create an oncology medical home that is designed to improve the care experience for cancer patients.

In the oncology medical home model, teams of cancer specialists collectively provide a patient’s health care when he or she has a cancer diagnosis. The model will give RCCA the responsibility to arrange appropriate care that is continuous and proactive and physicians will be incentivized for improved health, affordability and a better patient experience.

The oncology medical home arrangement will be available to patients at all RCCA locations in New Jersey and Maryland.

“RCCA is excited to partner with Aetna on this program. It aligns with our vision of providing patient centered care close to home,” said Terrill Jordan, RCCA President & CEO. “This partnership will not only enable us to continue the delivery of high quality care through reduced side effects, but will also facilitate cost effective care based on the data Aetna will be sharing,” said Michael Ruiz de Somocurcio, RCCA Vice President of Payer and Provider Collaboration.

The model is part of a strategic direction to transition from fee-for-service medicine to value-based payment. Value-based arrangements are emerging as a solution to address rising health care costs, clinical inefficiency, duplication of services, and access to care. In value-based models, doctors and hospitals are paid for helping to keep people healthy and for improving the health of those who have chronic conditions in an evidence-based, cost-effective way.

“We understand that cancer treatment can be the hardest experience that our members will ever have to go through,” said Daniel Knecht, M.D., M.B.A., Aetna’s Head of Strategy & Planning and Interim Head of Oncology Solutions. “This oncology medical home with RCCA will help provide our members with high-quality care and an optimal patient experience.”

The operating principles of the RCCA and Aetna oncology medical home include:

  • An orientation to the whole person. A personal physician from RCCA will be responsible for providing or arranging all of a patient’s health care needs with other qualified professionals. This includes care for all stages of treatment: preventive services, acute care, chronic care, palliative care and end-of-life care.
  • Evidence-based, personalized medical care. The RCCA team will focus on making treatment decisions based on current medical evidence for each unique disease presentation, patient-specific factors and patient choice using appropriate treatments to improve quality and outcomes.
  • Coordinated and integrated care. Care will be facilitated, across all elements of the health system, to enable Aetna members to get the appropriate care when and where it is needed and wanted, in a culturally and linguistically appropriate manner.
  • Quality and safety. Quality and safety will be a focus of care, including the use of evidence-based medicine, clinical decision support tools and accountability for continuous quality improvement.
  • Enhanced access to care. Care will be available through systems such as open scheduling, expanded hours and new options for communication between Aetna members, their personal physicians and hospital staff.

The oncology medical home arrangement launched in September 2016.

About RCCA

Regional Cancer Care Associates (RCCA), one of the largest oncology physician networks in the United States, is transforming oncology care by ensuring that cancer patients have access to the highest-quality, most-comprehensive, cutting edge treatments in a compassionate and community-based setting. RCCA includes 100 cancer care specialists and is supported by 700 employees at 27 care delivery sites, providing care to more than 23,000 new patients annually and over 230,000 existing patients in New Jersey, Maryland and Washington DC. For more information visit: http://www.RCCA.com.

About Aetna

Aetna is one of the nation’s leading diversified health care benefits companies, serving an estimated 46.3 million people with information and resources to help them make better informed decisions about their health care. Aetna offers a broad range of traditional, voluntary and consumer-directed health insurance products and related services, including medical, pharmacy, dental, behavioral health, group life and disability plans, and medical management capabilities, Medicaid health care management services, workers’ compensation administrative services and health information technology products and services. Aetna’s customers include employer groups, individuals, college students, part-time and hourly workers, health plans, health care providers, governmental units, government-sponsored plans, labor groups and expatriates. For more information, see www.aetna.com and learn about how Aetna is helping to build a healthier world. @AetnaNews

 

###

What Cancer Patients Need To Know About Clinical Trials: Insights From New Jersey Hematologist /Oncologist Seth Berk

Seth Howard Berk, MD, a hematologist and medical oncologist with RCCA, reveals four facts that he shares with his patients when they ask about clinical trials.

First, a drug has been thoroughly tested well before it reaches the clinical trial stage. Pre-clinical trial testing involves looking at a drug’s effects on animals as well as human cells. This stage usually takes years of development. Also, the clinical studies have to be designed and conducted in accordance with rigorous ethical and safety criteria.

He also imparts the importance of not thinking of clinical trials as a last resort in treatment. While trials are typically suited for situations in which traditional therapy methods are not working for a patient, there is more evidence emerging of late-stage trials benefitting the patient when used early in the diagnosis process.

A myth that Dr. Berk debunks is the use of a placebo in cancer treatment. Some cancer patients are resistant to clinical trials because they fear there will be a placebo and they will suffer as a result. He says this is misinformation or something assumed from a patient’s memory of high school or college science experiments. In clinical trials, one group will be administered the trial agent while the other continues to have traditional therapy. There are rarely ever patients receiving zero care.

Lastly, Dr. Berk addresses the importance of clinical trials for cancer patients in general. Because of willing patients participating in more and more trials, doctors and patients can share in a community of knowledge and understanding, and, one day, a cure.

To read more about clinical trials, turn to “What cancer patients need to know about clinical trials: Insights from New Jersey oncologist/hematologist Seth Berk.”

RCCA: Taking Cancer Care To A Higher Level In NJ And Beyond

Edward J. Licitra, MD, PhD, board certified in internal medicine, hematology and medical oncology and chairman of the board of directors of Regional Cancer Care Associates (RCCA), shares some of his thoughts on potential models for a health care delivery reform system. Oncologists at RCCA, totaling 100 physicians, learn from each other’s best practices with the patient’s interest at the forefront. Through RCCA, patients can receive care at home instead of visiting a hospital or clinic. They have set up 27 care delivery sites, providing care to more than 23,000 new patients annually and approximately 230,000 existing patients in New Jersey, Maryland and Washington, D.C.

Another example of a successful care reform case is the Oncology Care Model (OCM) created by Medicare under the Affordable Care Act (ACA). The model questions how to best develop an integrated style of cancer care. It focuses on developing a care model for the future, using data sharing and streamlining economics for patients as well as providers. By digitizing patients’ medical histories and sharing them through hospitals and clinics, this model focuses on simplifying the oncology care process.

Lastly, the OCM utilizes evidence-based-medicine (EBM) practices throughout the entire spectrum of care. EBM produces the best methods regardless of cost, while even reducing cost by eliminating wasteful spending. The OCM focuses on patient-focused, research based therapy tailored to the individual patient.

To learn more about this topic, read “RCCA: Taking cancer care to a higher level in NJ and beyond.”

Targeting Treatments for Chronic Lymphocytic Leukemia

Dr. Joel Silver

 

How do myeloma and chronic lymphocytic leukemia (CLL) develop? What are some risk factors associated with those malignancies?

A. We don’t know what causes CLL. We do know that people in some occupations or with a certain exposure history might be at higher risk, and that CLL generally affects older people. Treatment fortunately is not needed in many cases, but even so our treatment options have evolved based on cytogenetics and next-generation sequencing. We have more ways to assess prognostic features and design more personalized and potentially more effective therapy for people with CLL.

 

What therapies have been successful in treating CLL over the last two to three years?

A. If you can identify a certain kind of CLL, such as IDH-mutated CLL, some of the patients with it can receive a standard chemotherapy regimen called FCR, and they sometimes go into remission indefinitely. It depends on whether the patient is young and healthy enough to tolerate the therapy. That’s a select group, though; you don’t see too many young people with CLL.

Years ago, an effective treatment did not exist for another group of patients with CLL, those with the genetic 17p deletion. In recent years, however, the oral agent ibrutinib has shown effectiveness for CLL in this group. Other therapies now are available for patients who don’t respond to ibrutinib.

 

Where does targeted therapy come into play?

A. In general, “targeted therapy” refers to a treatment based on a particular mutation or pattern. The presence of the genetic 17p deletion in CLL is one example, but this is a bad cytogenetic abnormality for which standard treatments such as chemotherapy haven’t worked. If we can identify a particular mutation, then we can target our therapy and plan treatment that we know will work, instead of going through chemotherapies that are only partially effective or downright ineffective and then finding that the patient is resistant to treatment.

 

Are there side effects or drawbacks to targeted therapy?

A. Everything we do has side effects. The oral agent ibrutinib has been an effective first-line therapy for any type of CLL. Although the agent is specifically for patients with 17p deletion, it has also worked for patients without that genetic feature. While some cardiovascular and bleeding issues have been reported, ibrutinib overall is more tolerable than chemotherapy.

When we medically examine patients with CLL, we always look at a pattern of mutations to try to identify how to treat these people — not so much from an immediate therapeutic standpoint, but to gain knowledge of all these other cytogenetic abnormalities so that eventually, we will find other ways to target those different patterns.

What important points do you address with patients before they begin CLL therapy?

A. Many people with CLL don’t die of their disease, they die with their disease, so I tell patients not to be afraid of the disease itself. Many of the conversations we have with these people, however, revolve around the fact that they have this problem but may never need treatment. “We should follow you because you may need treatment down the line,” I tell them. “If you need treatment, we have many effective therapies.”

 

Do you foresee different therapies for CLL emerging within the next two to three years?

A. A number of medications are on the horizon that will be appropriate for any patient with CLL. For example, venetoclax, which gained FDA approval last year, is indicated for second-line treatment of CLL in patients with the 17p deletion, but I think that agent will be effective for all patients with CLL. As similarly versatile agents are developed, we will have many more treatment options.

Colorectal Cancer Trends in Maryland: A Conversation with Dr. Ralph V. Boccia

As the third most common cancer in the United States, colorectal cancer (CRC) affects about 1 in 20 Americans. However, incidence and death rates for cancer of the colorectum have significantly decreased over the past several decades as a result of increased screening and drastic improvements in treatment. In Maryland alone, approximately 70% of adults over the age of 50 have an up-to-date colorectal cancer screening, helping contribute to the reduction in mortality rates.

Dr. Ralph V. Boccia, an oncology and hematology specialist at Regional Cancer Care Associates (RCCA) in Bethesda and Germantown, Maryland says, “The more colorectal screening we have and the earlier it gets started, the lower the stage that the cancer is typically picked up.” In turn, early detection has led to the state’s lower mortality rates over time.

 

The Benefits Of Increased Screening

According to Dr. Boccia, improving screening rates “affects the stage at which the cancer presents itself and [the patient’s] potential for survival.” Between 2002 and 2010, the percentage of Maryland adults with up-to-date colorectal cancer screenings increased from 64% to 71%. As a result, CRC mortality rates in Maryland decreased considerably among both men and women in that eight-year timeframe. Dr. Boccia explains, “The trend we’ve actually seen – which is that more people are being screened – has resulted in more improvements of overall survival in patients with colorectal cancer.”

However, as colon cancer rates decline in adults 50 years and older, both incidence and death rates are increasing in the under-50 population. “We’re seeing a scary trend of younger patients getting colorectal cancer,” remarks Dr. Boccia, “even down into the 20s.” However, at this point in time, there’s insufficient data to clearly identify the causation behind this trend.

 

Colorectal Cancer Risk Factors

According to a report from the Maryland Department of Health and Mental Hygiene, the incidence rate of colon cancer per 100,000 people in Maryland was 1,174 for men and 1,109 for women in 2012. When looking at new cases of CRC, research shows that incidence may be tied to habits and lifestyles. Among these lifestyle- associated risk factors are being overweight or obese, lack of physical activity, smoking, heavy alcohol use and certain types of diets.

As outlined by the American Cancer Society, other risk factors unrelated to lifestyle choices are personal and family histories of colorectal cancer or adenomatous polyps, having type 2 diabetes, possessing an inherited syndrome, such as Lynch Syndrome, and certain racial and ethnic backgrounds. In addition, Dr. Boccia notes that a personal history of inflammatory bowel disease may increase the risk for developing colorectal cancer. “Patients with ulcerative colitis have to be screened very frequently for colon cancer,” Dr. Boccia elucidates, “because of that high predisposition.”

 

Common CRC Treatments

“For early stage colorectal cancer, the treatment of choice is surgery,” says Dr. Boccia. In this stage, a group of abnormal cells, referred to as carcinoma in situ (CIS), can be removed by a polypectomy, or a part of the colon can be removed via a partial colectomy. Once the cancer has penetrated the wall of the colon and perhaps even grown into nearby tissue, patients of RCCA Maryland will typically undergo active surveillance – although other treatment options are offered to those with high-risk tumors, says Dr. Boccia.

Once the cancer has reached Stage III, patients are generally offered a form of chemotherapy for roughly six weeks. “FOLFOX is the adjuvant therapy of choice,” says Dr. Boccia, “and that we know will lower the incidence of recurrence by about 40-50%.” For Stage IV diseases, which make up about 20% of the cases that RCCA Maryland sees each year, chemotherapy, targeted therapy and even immunotherapy can be used to offer aggressive treatment. If they no longer respond to a particular drug, patients will be introduced to a new regimen.

In regards to new research and treatment options, Dr. Boccia concludes, “I have 50 to 60 clinical trials open at all times in the center, so we’re always looking actively for good, cutting-edge therapies and offering those to our patients.”

 

If you or someone you love has been diagnosed with colorectal cancer, schedule an appointment at one of RCCA’s 29 locations in New Jersey, Maryland or Connecticut for personalized, professional care.

Molecular Testing: Tailoring Treatment by Targeting Pathways

Phillip D. Reid, MD

 

What is molecular testing? How it is used in cancer care?

A.  As we learn how to treat specific subtypes of cancer more accurately, molecular testing, molecular medicine and molecular diagnostics are becoming more prominent in oncology.

In the past, once a cancer was diagnosed, we determined the organ where it started, how much cancer was in the body and where it was. We have since discovered many pathways through which a cancer develops. We now need to know not only the stage, type and origin of cancer, but also the pathway through which it developed and then target that pathway.

 

How does the pathway concept affect therapy selection?

A.  It enhances our ability to treat the cancer, but we now need extra testing on a patient’s particular cancer cells. The great thing about molecular testing is we get an answer specific for the individual, not just for everyone, for example, with lung cancer. But it does require more time for us to find the pathway. From the patient’s standpoint, diagnosis and stage are obtained, and then sometimes we have to send off the cancer cells for extra testing, which increases the time between diagnosis and treatment. But ultimately, a better sense is provided of what drug to use and when to use it, and there’s a much greater likelihood of devising specific, effective treatment.

 

For which types of cancer should molecular testing be used?

A.  Molecular testing has revolutionized every major cancer diagnosis. Patients with lung and breast cancer are the best candidates, but molecular testing also is useful in colon cancer, head-and-neck and bladder cancer, and some leukemias and myelomas.

 

What have been the main developments over the last two to three years with molecular testing?

A.  It’s becoming easier and more standardized to get molecular testing done. A patient receives a diagnosis and his or her cancer is sent off to a lab, which evaluates all known pathways for that cancer. A specific result is received. As the patient receives therapy, sometimes the cancer changes and he or she may need a second or third biopsy one to three years after the initial diagnosis to see what’s changed in the cancer, and then the treatment changes based on that result. We now see cancer as a moving target as it progresses, and we have to recalibrate every few years so that we’re shooting that target correctly.

 

What should patients know about molecular testing before proceeding?

A.  After a patient receives his or her staging diagnosis, the next question is, “What subtype of lung cancer do I have and what pathway did the cancer use to develop?” The patient needs to have patience, as that extra information may not arrive for two to four weeks, but that information can increase the chances of treatment success.

Also ask about clinical trials of cancer medications before beginning therapy, because we often know about upcoming medications that are effective and possibly better than what we have right now.

Colorectal Cancer Trends and Treatment

Ralph V. Boccia, MD, a cancer specialist at RCCA Maryland, provides some insight into recent colorectal cancer trends and treatments that are giving new hope to doctors, researchers and patients nationwide. Overall, Dr. Boccia finds much to be encouraged by, but also points to the need for awareness of a concerning development in the field of colorectal cancer.

 

How Far We’ve Come and Where We’re Going

As a whole, colorectal cancer rates have been dropping. According to the National Cancer Institute and Centers for Disease Control and Prevention, Maryland alone has seen a 2.6% decrease in the amount of new CRC patients diagnosed over a five-year period. Dr. Boccia believes this trend can be partly attributed to the following:

  • Widespread increase in colonoscopies and other CRC screening methods
  • Early detection and removal of polyps before they become cancerous
  • More cases being diagnosed at an early stage – when the cancer is more responsive to treatment

Despite the good news, it’s still projected that 2,358 Maryland residents will be diagnosed and that 927 people will die from the disease this year, says Dr. Boccia. Doctors have also been noticing an uncharacteristic increase in the amount of younger adults being diagnosed with CRC. Since it typically affects individuals above the age of 50, this emerging demographic has been cause for concern. But Dr. Boccia and his colleagues will continue to conduct research and make further strides in colorectal cancer care to better serve patients of all ages.

 

Current Treatment Options

Surgical innovations, targeted therapies, immunotherapies, chemotherapy and clinical trials are paving the way for more effective CRC solutions. Dr. Boccia explains, “We have a greater ability than ever before to individualize care, and to offer patients multi-modal treatment regimens that employ a variety of mechanisms of action to combat cancer by different means.”

 

Reducing Your Risk

Follow these tips to help reduce your risk for developing colorectal cancer:

  • Maintain a healthy weight
  • Stay physically active
  • Avoid smoking cigarettes and only drink alcohol in moderation
  • Get a CRC screening regularly
  • Consult a physician right away if you experience any CRC symptoms, such as blood in the stool and persistent abdominal pain
  • Manage other conditions that may increase your risk for CRC, like type 2 diabetes, inflammatory bowel disease and adenomatous polyps

 

If you or someone you love has been diagnosed with colorectal cancer, schedule an appointment at one of RCCA’s 29 locations in New Jersey, Maryland or Connecticut for personalized, professional care.

RCCA Earns URAC Accreditation In Specialty Pharmacy

[Hackensack, NJ] – RCCA is proud to announce that it has earned URAC accreditation in Specialty Pharmacy. URAC is the independent leader in promoting healthcare quality through accreditation, certification and measurement. By achieving this status, RCCA has demonstrated a comprehensive commitment to quality care, improved processes and better patient outcomes.

 

“URAC Accreditation is a testament to the commitment of delivering the highest level of quality standards to our patients and their caregivers,” said Terrill Jordan, President and CEO of RCCA. ”This type of commitment is the cornerstone of everything we do at RCCA,” he added.

Edward Licitra, MD, PhD, RCCA Chairperson of the Board and RCCA Pharmacy Medical Director and Eileen Peng, PharmD, Director of the RCCA Pharmacy agree that “this new recognition will allow us to continue to provide the highest level of patient care and convenience for the people that need it the most.”

 

“Pharmacy services have never played such an important role in the delivery of care as they do today. RCCA distinguishes itself for having voluntarily undergone a rigorous review of quality standards that earned it URAC accreditation,” said URAC President and CEO Kylanne Green. “Independent URAC accreditation shows RCCA is dedicated to quality and safety, and that it strives for a continual improvement of its services.”

ABOUT RCCA

Regional Cancer Care Associates (RCCA), one of the largest oncology physician networks in the United States, is transforming oncology care by ensuring that cancer patients have access to the highest-quality, most-comprehensive, cutting edge treatments in a compassionate and community-based setting. RCCA includes more than 100 cancer care specialists and is supported by 800 employees at more than 30 care delivery sites, providing care to more than 24,000 new patients annually and over 240,000 existing patients.  For more information visit: http://www.RCCA.com

About URAC

Founded in 1990, URAC is the independent leader in promoting healthcare quality through accreditation, certification and measurement. URAC is a nonprofit organization developing evidence-based measures and standards through inclusive engagement with a range of stakeholders committed to improving the quality of healthcare. Our portfolio of accreditation and certification programs span the healthcare industry, addressing healthcare management, healthcare operations, health plans, pharmacies, telehealth providers, physician practices, and more. URAC accreditation is a symbol of excellence for organizations to showcase their validated commitment to quality and accountability.

For further information, contact:

Mary Lou Salvemini
msalvemini@regionalcancercare.org
(201) 510-0922

RCCA Makes Innovative UnitedHealthcare Cancer Care Program Available to Patients in Maryland

HACKENSACK, N.J., Nov. 22, 2016 /PRNewswire-USNewswire/ — Regional Cancer Care Associates (RCCA) is expanding its cancer care payment initiative with UnitedHealthcare to RCCA patients in Maryland who are covered by UnitedHealthcare benefit plans.

The program, made available at RCCA New Jersey locations in January, rewards physicians for focusing on best treatment practices, quality patient care and better health outcomes. The program pays participating medical oncologists more if they demonstrate superior clinical results and if they reduce the total cost of care.

The episode payment model shifts reimbursement away from the current “fee-for-service” approach that emphasizes volume of care delivered regardless of a patient’s health outcomes. The episode payment is based on the expected cost of a standard treatment regimen for a specific condition, as predetermined by the doctor. Similar payment models have been shown to enhance care coordination and improve health outcomes for patients, while reducing overall costs.

“RCCA has emerged as a leader in delivering the highest-level quality cancer care to our patients,” said Terrill Jordan, RCCA President and CEO. “New payment methodologies like this put patients’ interests at the forefront of cancer treatment. It also results in significant cost savings, which advances efforts across the country to assist in controlling rising health care costs. We are excited to offer this program to our Maryland patient base.”

Lee N. Newcomer, M.D., UnitedHealthcare’s Senior Vice President, Oncology, said: “Our partnership with RCCA marks an important step toward expanded episode payment models and away from the traditional fee-for-service payments for oncology care. We look forward to working with RCCA and others to expand our efforts to identify best practices for treating cancer.”

A study published in the Journal of Oncology Practice has demonstrated that this program reduced overall cancer expenses by more than a third while improving quality outcomes. RCCA is among five oncology practices that have joined the program, which now has a total of more than 650 oncologists. RCCA in New Jersey and now Maryland comprise approximately 100 of these oncologists.

“Value-based cancer care is here. This program will enable Maryland-based RCCA oncologists to continue to provide patient-centered care at the highest level of quality,” said Ralph Boccia, M.D., RCCA Research Deputy Chair and Oncologist in Bethesda and Germantown, Md.

UnitedHealthcare first implemented its episode payment program as a pilot study between October 2009 and December 2012. The pilot study produced a significant reduction in hospitalizations and a 34 percent reduction in total costs while improving quality. Click here to read results of the study.

About RCCA
Regional Cancer Care Associates (RCCA), one of the largest oncology physician networks in the United States, is transforming oncology care by ensuring that cancer patients have access to the highest-quality, most-comprehensive, cutting edge treatments in a compassionate and community-based setting. RCCA includes 100 cancer care specialists and is supported by 700 employees at 27 care delivery sites, providing care to more than 230,000 existing patients in New Jersey, Maryland and Washington DC.  For more information visit: http://www.RCCA.com

Contact:

Mary Lou Salvemini
msalvemini@regionalcancercare.org
(201) 510-0922

REGIONAL CANCER CARE ASSOCIATES AND AETNA FORM ONCOLOGY MEDICAL HOME

REGIONAL CANCER CARE ASSOCIATES AND AETNA FORM ONCOLOGY MEDICAL HOME

— The Patient-Focused Model Supports High-Value Care–

 

Hackensack, NJ, October 12, 2016 — Regional Cancer Care Associates (RCCA) and Aetna (NYSE: AET) announced a collaboration to create an oncology medical home that is designed to improve the care experience for cancer patients.

In the oncology medical home model, teams of cancer specialists collectively provide a patient’s health care when he or she has a cancer diagnosis. The model will give RCCA the responsibility to arrange appropriate care that is continuous and proactive and physicians will be incentivized for improved health, affordability and a better patient experience.

The oncology medical home arrangement will be available to patients at all RCCA locations in New Jersey and Maryland.

“RCCA is excited to partner with Aetna on this program. It aligns with our vision of providing patient centered care close to home,” said Terrill Jordan, RCCA President & CEO. “This partnership will not only enable us to continue the delivery of high quality care through reduced side effects, but will also facilitate cost effective care based on the data Aetna will be sharing,” said Michael Ruiz de Somocurcio, RCCA Vice President of Payer and Provider Collaboration.

The model is part of a strategic direction to transition from fee-for-service medicine to value-based payment. Value-based arrangements are emerging as a solution to address rising health care costs, clinical inefficiency, duplication of services, and access to care. In value-based models, doctors and hospitals are paid for helping to keep people healthy and for improving the health of those who have chronic conditions in an evidence-based, cost-effective way.

“We understand that cancer treatment can be the hardest experience that our members will ever have to go through,” said Daniel Knecht, M.D., M.B.A., Aetna’s Head of Strategy & Planning and Interim Head of Oncology Solutions. “This oncology medical home with RCCA will help provide our members with high-quality care and an optimal patient experience.”

The operating principles of the RCCA and Aetna oncology medical home include:

  • An orientation to the whole person. A personal physician from RCCA will be responsible for providing or arranging all of a patient’s health care needs with other qualified professionals. This includes care for all stages of treatment: preventive services, acute care, chronic care, palliative care and end-of-life care.
  • Evidence-based, personalized medical care. The RCCA team will focus on making treatment decisions based on current medical evidence for each unique disease presentation, patient-specific factors and patient choice using appropriate treatments to improve quality and outcomes.
  • Coordinated and integrated care. Care will be facilitated, across all elements of the health system, to enable Aetna members to get the appropriate care when and where it is needed and wanted, in a culturally and linguistically appropriate manner.
  • Quality and safety. Quality and safety will be a focus of care, including the use of evidence-based medicine, clinical decision support tools and accountability for continuous quality improvement.
  • Enhanced access to care. Care will be available through systems such as open scheduling, expanded hours and new options for communication between Aetna members, their personal physicians and hospital staff.

The oncology medical home arrangement launched in September 2016.

About RCCA

Regional Cancer Care Associates (RCCA), one of the largest oncology physician networks in the United States, is transforming oncology care by ensuring that cancer patients have access to the highest-quality, most-comprehensive, cutting edge treatments in a compassionate and community-based setting. RCCA includes 100 cancer care specialists and is supported by 700 employees at 27 care delivery sites, providing care to more than 23,000 new patients annually and over 230,000 existing patients in New Jersey, Maryland and Washington DC. For more information visit: http://www.RCCA.com.

About Aetna

Aetna is one of the nation’s leading diversified health care benefits companies, serving an estimated 46.3 million people with information and resources to help them make better informed decisions about their health care. Aetna offers a broad range of traditional, voluntary and consumer-directed health insurance products and related services, including medical, pharmacy, dental, behavioral health, group life and disability plans, and medical management capabilities, Medicaid health care management services, workers’ compensation administrative services and health information technology products and services. Aetna’s customers include employer groups, individuals, college students, part-time and hourly workers, health plans, health care providers, governmental units, government-sponsored plans, labor groups and expatriates. For more information, see www.aetna.com and learn about how Aetna is helping to build a healthier world. @AetnaNews

 

###

What Cancer Patients Need To Know About Clinical Trials: Insights From New Jersey Hematologist /Oncologist Seth Berk

Seth Howard Berk, MD, a hematologist and medical oncologist with RCCA, reveals four facts that he shares with his patients when they ask about clinical trials.

First, a drug has been thoroughly tested well before it reaches the clinical trial stage. Pre-clinical trial testing involves looking at a drug’s effects on animals as well as human cells. This stage usually takes years of development. Also, the clinical studies have to be designed and conducted in accordance with rigorous ethical and safety criteria.

He also imparts the importance of not thinking of clinical trials as a last resort in treatment. While trials are typically suited for situations in which traditional therapy methods are not working for a patient, there is more evidence emerging of late-stage trials benefitting the patient when used early in the diagnosis process.

A myth that Dr. Berk debunks is the use of a placebo in cancer treatment. Some cancer patients are resistant to clinical trials because they fear there will be a placebo and they will suffer as a result. He says this is misinformation or something assumed from a patient’s memory of high school or college science experiments. In clinical trials, one group will be administered the trial agent while the other continues to have traditional therapy. There are rarely ever patients receiving zero care.

Lastly, Dr. Berk addresses the importance of clinical trials for cancer patients in general. Because of willing patients participating in more and more trials, doctors and patients can share in a community of knowledge and understanding, and, one day, a cure.

To read more about clinical trials, turn to “What cancer patients need to know about clinical trials: Insights from New Jersey oncologist/hematologist Seth Berk.”

RCCA: Taking Cancer Care To A Higher Level In NJ And Beyond

Edward J. Licitra, MD, PhD, board certified in internal medicine, hematology and medical oncology and chairman of the board of directors of Regional Cancer Care Associates (RCCA), shares some of his thoughts on potential models for a health care delivery reform system. Oncologists at RCCA, totaling 100 physicians, learn from each other’s best practices with the patient’s interest at the forefront. Through RCCA, patients can receive care at home instead of visiting a hospital or clinic. They have set up 27 care delivery sites, providing care to more than 23,000 new patients annually and approximately 230,000 existing patients in New Jersey, Maryland and Washington, D.C.

Another example of a successful care reform case is the Oncology Care Model (OCM) created by Medicare under the Affordable Care Act (ACA). The model questions how to best develop an integrated style of cancer care. It focuses on developing a care model for the future, using data sharing and streamlining economics for patients as well as providers. By digitizing patients’ medical histories and sharing them through hospitals and clinics, this model focuses on simplifying the oncology care process.

Lastly, the OCM utilizes evidence-based-medicine (EBM) practices throughout the entire spectrum of care. EBM produces the best methods regardless of cost, while even reducing cost by eliminating wasteful spending. The OCM focuses on patient-focused, research based therapy tailored to the individual patient.

To learn more about this topic, read “RCCA: Taking cancer care to a higher level in NJ and beyond.”

Targeting Treatments for Chronic Lymphocytic Leukemia

Dr. Joel Silver

 

How do myeloma and chronic lymphocytic leukemia (CLL) develop? What are some risk factors associated with those malignancies?

A. We don’t know what causes CLL. We do know that people in some occupations or with a certain exposure history might be at higher risk, and that CLL generally affects older people. Treatment fortunately is not needed in many cases, but even so our treatment options have evolved based on cytogenetics and next-generation sequencing. We have more ways to assess prognostic features and design more personalized and potentially more effective therapy for people with CLL.

 

What therapies have been successful in treating CLL over the last two to three years?

A. If you can identify a certain kind of CLL, such as IDH-mutated CLL, some of the patients with it can receive a standard chemotherapy regimen called FCR, and they sometimes go into remission indefinitely. It depends on whether the patient is young and healthy enough to tolerate the therapy. That’s a select group, though; you don’t see too many young people with CLL.

Years ago, an effective treatment did not exist for another group of patients with CLL, those with the genetic 17p deletion. In recent years, however, the oral agent ibrutinib has shown effectiveness for CLL in this group. Other therapies now are available for patients who don’t respond to ibrutinib.

 

Where does targeted therapy come into play?

A. In general, “targeted therapy” refers to a treatment based on a particular mutation or pattern. The presence of the genetic 17p deletion in CLL is one example, but this is a bad cytogenetic abnormality for which standard treatments such as chemotherapy haven’t worked. If we can identify a particular mutation, then we can target our therapy and plan treatment that we know will work, instead of going through chemotherapies that are only partially effective or downright ineffective and then finding that the patient is resistant to treatment.

 

Are there side effects or drawbacks to targeted therapy?

A. Everything we do has side effects. The oral agent ibrutinib has been an effective first-line therapy for any type of CLL. Although the agent is specifically for patients with 17p deletion, it has also worked for patients without that genetic feature. While some cardiovascular and bleeding issues have been reported, ibrutinib overall is more tolerable than chemotherapy.

When we medically examine patients with CLL, we always look at a pattern of mutations to try to identify how to treat these people — not so much from an immediate therapeutic standpoint, but to gain knowledge of all these other cytogenetic abnormalities so that eventually, we will find other ways to target those different patterns.

What important points do you address with patients before they begin CLL therapy?

A. Many people with CLL don’t die of their disease, they die with their disease, so I tell patients not to be afraid of the disease itself. Many of the conversations we have with these people, however, revolve around the fact that they have this problem but may never need treatment. “We should follow you because you may need treatment down the line,” I tell them. “If you need treatment, we have many effective therapies.”

 

Do you foresee different therapies for CLL emerging within the next two to three years?

A. A number of medications are on the horizon that will be appropriate for any patient with CLL. For example, venetoclax, which gained FDA approval last year, is indicated for second-line treatment of CLL in patients with the 17p deletion, but I think that agent will be effective for all patients with CLL. As similarly versatile agents are developed, we will have many more treatment options.

Colorectal Cancer Trends in Maryland: A Conversation with Dr. Ralph V. Boccia

As the third most common cancer in the United States, colorectal cancer (CRC) affects about 1 in 20 Americans. However, incidence and death rates for cancer of the colorectum have significantly decreased over the past several decades as a result of increased screening and drastic improvements in treatment. In Maryland alone, approximately 70% of adults over the age of 50 have an up-to-date colorectal cancer screening, helping contribute to the reduction in mortality rates.

Dr. Ralph V. Boccia, an oncology and hematology specialist at Regional Cancer Care Associates (RCCA) in Bethesda and Germantown, Maryland says, “The more colorectal screening we have and the earlier it gets started, the lower the stage that the cancer is typically picked up.” In turn, early detection has led to the state’s lower mortality rates over time.

 

The Benefits Of Increased Screening

According to Dr. Boccia, improving screening rates “affects the stage at which the cancer presents itself and [the patient’s] potential for survival.” Between 2002 and 2010, the percentage of Maryland adults with up-to-date colorectal cancer screenings increased from 64% to 71%. As a result, CRC mortality rates in Maryland decreased considerably among both men and women in that eight-year timeframe. Dr. Boccia explains, “The trend we’ve actually seen – which is that more people are being screened – has resulted in more improvements of overall survival in patients with colorectal cancer.”

However, as colon cancer rates decline in adults 50 years and older, both incidence and death rates are increasing in the under-50 population. “We’re seeing a scary trend of younger patients getting colorectal cancer,” remarks Dr. Boccia, “even down into the 20s.” However, at this point in time, there’s insufficient data to clearly identify the causation behind this trend.

 

Colorectal Cancer Risk Factors

According to a report from the Maryland Department of Health and Mental Hygiene, the incidence rate of colon cancer per 100,000 people in Maryland was 1,174 for men and 1,109 for women in 2012. When looking at new cases of CRC, research shows that incidence may be tied to habits and lifestyles. Among these lifestyle- associated risk factors are being overweight or obese, lack of physical activity, smoking, heavy alcohol use and certain types of diets.

As outlined by the American Cancer Society, other risk factors unrelated to lifestyle choices are personal and family histories of colorectal cancer or adenomatous polyps, having type 2 diabetes, possessing an inherited syndrome, such as Lynch Syndrome, and certain racial and ethnic backgrounds. In addition, Dr. Boccia notes that a personal history of inflammatory bowel disease may increase the risk for developing colorectal cancer. “Patients with ulcerative colitis have to be screened very frequently for colon cancer,” Dr. Boccia elucidates, “because of that high predisposition.”

 

Common CRC Treatments

“For early stage colorectal cancer, the treatment of choice is surgery,” says Dr. Boccia. In this stage, a group of abnormal cells, referred to as carcinoma in situ (CIS), can be removed by a polypectomy, or a part of the colon can be removed via a partial colectomy. Once the cancer has penetrated the wall of the colon and perhaps even grown into nearby tissue, patients of RCCA Maryland will typically undergo active surveillance – although other treatment options are offered to those with high-risk tumors, says Dr. Boccia.

Once the cancer has reached Stage III, patients are generally offered a form of chemotherapy for roughly six weeks. “FOLFOX is the adjuvant therapy of choice,” says Dr. Boccia, “and that we know will lower the incidence of recurrence by about 40-50%.” For Stage IV diseases, which make up about 20% of the cases that RCCA Maryland sees each year, chemotherapy, targeted therapy and even immunotherapy can be used to offer aggressive treatment. If they no longer respond to a particular drug, patients will be introduced to a new regimen.

In regards to new research and treatment options, Dr. Boccia concludes, “I have 50 to 60 clinical trials open at all times in the center, so we’re always looking actively for good, cutting-edge therapies and offering those to our patients.”

 

If you or someone you love has been diagnosed with colorectal cancer, schedule an appointment at one of RCCA’s 29 locations in New Jersey, Maryland or Connecticut for personalized, professional care.

Molecular Testing: Tailoring Treatment by Targeting Pathways

Phillip D. Reid, MD

 

What is molecular testing? How it is used in cancer care?

A.  As we learn how to treat specific subtypes of cancer more accurately, molecular testing, molecular medicine and molecular diagnostics are becoming more prominent in oncology.

In the past, once a cancer was diagnosed, we determined the organ where it started, how much cancer was in the body and where it was. We have since discovered many pathways through which a cancer develops. We now need to know not only the stage, type and origin of cancer, but also the pathway through which it developed and then target that pathway.

 

How does the pathway concept affect therapy selection?

A.  It enhances our ability to treat the cancer, but we now need extra testing on a patient’s particular cancer cells. The great thing about molecular testing is we get an answer specific for the individual, not just for everyone, for example, with lung cancer. But it does require more time for us to find the pathway. From the patient’s standpoint, diagnosis and stage are obtained, and then sometimes we have to send off the cancer cells for extra testing, which increases the time between diagnosis and treatment. But ultimately, a better sense is provided of what drug to use and when to use it, and there’s a much greater likelihood of devising specific, effective treatment.

 

For which types of cancer should molecular testing be used?

A.  Molecular testing has revolutionized every major cancer diagnosis. Patients with lung and breast cancer are the best candidates, but molecular testing also is useful in colon cancer, head-and-neck and bladder cancer, and some leukemias and myelomas.

 

What have been the main developments over the last two to three years with molecular testing?

A.  It’s becoming easier and more standardized to get molecular testing done. A patient receives a diagnosis and his or her cancer is sent off to a lab, which evaluates all known pathways for that cancer. A specific result is received. As the patient receives therapy, sometimes the cancer changes and he or she may need a second or third biopsy one to three years after the initial diagnosis to see what’s changed in the cancer, and then the treatment changes based on that result. We now see cancer as a moving target as it progresses, and we have to recalibrate every few years so that we’re shooting that target correctly.

 

What should patients know about molecular testing before proceeding?

A.  After a patient receives his or her staging diagnosis, the next question is, “What subtype of lung cancer do I have and what pathway did the cancer use to develop?” The patient needs to have patience, as that extra information may not arrive for two to four weeks, but that information can increase the chances of treatment success.

Also ask about clinical trials of cancer medications before beginning therapy, because we often know about upcoming medications that are effective and possibly better than what we have right now.

Colorectal Cancer Trends and Treatment

Ralph V. Boccia, MD, a cancer specialist at RCCA Maryland, provides some insight into recent colorectal cancer trends and treatments that are giving new hope to doctors, researchers and patients nationwide. Overall, Dr. Boccia finds much to be encouraged by, but also points to the need for awareness of a concerning development in the field of colorectal cancer.

 

How Far We’ve Come and Where We’re Going

As a whole, colorectal cancer rates have been dropping. According to the National Cancer Institute and Centers for Disease Control and Prevention, Maryland alone has seen a 2.6% decrease in the amount of new CRC patients diagnosed over a five-year period. Dr. Boccia believes this trend can be partly attributed to the following:

  • Widespread increase in colonoscopies and other CRC screening methods
  • Early detection and removal of polyps before they become cancerous
  • More cases being diagnosed at an early stage – when the cancer is more responsive to treatment

Despite the good news, it’s still projected that 2,358 Maryland residents will be diagnosed and that 927 people will die from the disease this year, says Dr. Boccia. Doctors have also been noticing an uncharacteristic increase in the amount of younger adults being diagnosed with CRC. Since it typically affects individuals above the age of 50, this emerging demographic has been cause for concern. But Dr. Boccia and his colleagues will continue to conduct research and make further strides in colorectal cancer care to better serve patients of all ages.

 

Current Treatment Options

Surgical innovations, targeted therapies, immunotherapies, chemotherapy and clinical trials are paving the way for more effective CRC solutions. Dr. Boccia explains, “We have a greater ability than ever before to individualize care, and to offer patients multi-modal treatment regimens that employ a variety of mechanisms of action to combat cancer by different means.”

 

Reducing Your Risk

Follow these tips to help reduce your risk for developing colorectal cancer:

  • Maintain a healthy weight
  • Stay physically active
  • Avoid smoking cigarettes and only drink alcohol in moderation
  • Get a CRC screening regularly
  • Consult a physician right away if you experience any CRC symptoms, such as blood in the stool and persistent abdominal pain
  • Manage other conditions that may increase your risk for CRC, like type 2 diabetes, inflammatory bowel disease and adenomatous polyps

 

If you or someone you love has been diagnosed with colorectal cancer, schedule an appointment at one of RCCA’s 29 locations in New Jersey, Maryland or Connecticut for personalized, professional care.

RCCA Earns URAC Accreditation In Specialty Pharmacy

[Hackensack, NJ] – RCCA is proud to announce that it has earned URAC accreditation in Specialty Pharmacy. URAC is the independent leader in promoting healthcare quality through accreditation, certification and measurement. By achieving this status, RCCA has demonstrated a comprehensive commitment to quality care, improved processes and better patient outcomes.

 

“URAC Accreditation is a testament to the commitment of delivering the highest level of quality standards to our patients and their caregivers,” said Terrill Jordan, President and CEO of RCCA. ”This type of commitment is the cornerstone of everything we do at RCCA,” he added.

Edward Licitra, MD, PhD, RCCA Chairperson of the Board and RCCA Pharmacy Medical Director and Eileen Peng, PharmD, Director of the RCCA Pharmacy agree that “this new recognition will allow us to continue to provide the highest level of patient care and convenience for the people that need it the most.”

 

“Pharmacy services have never played such an important role in the delivery of care as they do today. RCCA distinguishes itself for having voluntarily undergone a rigorous review of quality standards that earned it URAC accreditation,” said URAC President and CEO Kylanne Green. “Independent URAC accreditation shows RCCA is dedicated to quality and safety, and that it strives for a continual improvement of its services.”

ABOUT RCCA

Regional Cancer Care Associates (RCCA), one of the largest oncology physician networks in the United States, is transforming oncology care by ensuring that cancer patients have access to the highest-quality, most-comprehensive, cutting edge treatments in a compassionate and community-based setting. RCCA includes more than 100 cancer care specialists and is supported by 800 employees at more than 30 care delivery sites, providing care to more than 24,000 new patients annually and over 240,000 existing patients.  For more information visit: http://www.RCCA.com

About URAC

Founded in 1990, URAC is the independent leader in promoting healthcare quality through accreditation, certification and measurement. URAC is a nonprofit organization developing evidence-based measures and standards through inclusive engagement with a range of stakeholders committed to improving the quality of healthcare. Our portfolio of accreditation and certification programs span the healthcare industry, addressing healthcare management, healthcare operations, health plans, pharmacies, telehealth providers, physician practices, and more. URAC accreditation is a symbol of excellence for organizations to showcase their validated commitment to quality and accountability.

For further information, contact:

Mary Lou Salvemini
msalvemini@regionalcancercare.org
(201) 510-0922

RCCA Makes Innovative UnitedHealthcare Cancer Care Program Available to Patients in Maryland

HACKENSACK, N.J., Nov. 22, 2016 /PRNewswire-USNewswire/ — Regional Cancer Care Associates (RCCA) is expanding its cancer care payment initiative with UnitedHealthcare to RCCA patients in Maryland who are covered by UnitedHealthcare benefit plans.

The program, made available at RCCA New Jersey locations in January, rewards physicians for focusing on best treatment practices, quality patient care and better health outcomes. The program pays participating medical oncologists more if they demonstrate superior clinical results and if they reduce the total cost of care.

The episode payment model shifts reimbursement away from the current “fee-for-service” approach that emphasizes volume of care delivered regardless of a patient’s health outcomes. The episode payment is based on the expected cost of a standard treatment regimen for a specific condition, as predetermined by the doctor. Similar payment models have been shown to enhance care coordination and improve health outcomes for patients, while reducing overall costs.

“RCCA has emerged as a leader in delivering the highest-level quality cancer care to our patients,” said Terrill Jordan, RCCA President and CEO. “New payment methodologies like this put patients’ interests at the forefront of cancer treatment. It also results in significant cost savings, which advances efforts across the country to assist in controlling rising health care costs. We are excited to offer this program to our Maryland patient base.”

Lee N. Newcomer, M.D., UnitedHealthcare’s Senior Vice President, Oncology, said: “Our partnership with RCCA marks an important step toward expanded episode payment models and away from the traditional fee-for-service payments for oncology care. We look forward to working with RCCA and others to expand our efforts to identify best practices for treating cancer.”

A study published in the Journal of Oncology Practice has demonstrated that this program reduced overall cancer expenses by more than a third while improving quality outcomes. RCCA is among five oncology practices that have joined the program, which now has a total of more than 650 oncologists. RCCA in New Jersey and now Maryland comprise approximately 100 of these oncologists.

“Value-based cancer care is here. This program will enable Maryland-based RCCA oncologists to continue to provide patient-centered care at the highest level of quality,” said Ralph Boccia, M.D., RCCA Research Deputy Chair and Oncologist in Bethesda and Germantown, Md.

UnitedHealthcare first implemented its episode payment program as a pilot study between October 2009 and December 2012. The pilot study produced a significant reduction in hospitalizations and a 34 percent reduction in total costs while improving quality. Click here to read results of the study.

About RCCA
Regional Cancer Care Associates (RCCA), one of the largest oncology physician networks in the United States, is transforming oncology care by ensuring that cancer patients have access to the highest-quality, most-comprehensive, cutting edge treatments in a compassionate and community-based setting. RCCA includes 100 cancer care specialists and is supported by 700 employees at 27 care delivery sites, providing care to more than 230,000 existing patients in New Jersey, Maryland and Washington DC.  For more information visit: http://www.RCCA.com

Contact:

Mary Lou Salvemini
msalvemini@regionalcancercare.org
(201) 510-0922

REGIONAL CANCER CARE ASSOCIATES AND AETNA FORM ONCOLOGY MEDICAL HOME

REGIONAL CANCER CARE ASSOCIATES AND AETNA FORM ONCOLOGY MEDICAL HOME

— The Patient-Focused Model Supports High-Value Care–

 

Hackensack, NJ, October 12, 2016 — Regional Cancer Care Associates (RCCA) and Aetna (NYSE: AET) announced a collaboration to create an oncology medical home that is designed to improve the care experience for cancer patients.

In the oncology medical home model, teams of cancer specialists collectively provide a patient’s health care when he or she has a cancer diagnosis. The model will give RCCA the responsibility to arrange appropriate care that is continuous and proactive and physicians will be incentivized for improved health, affordability and a better patient experience.

The oncology medical home arrangement will be available to patients at all RCCA locations in New Jersey and Maryland.

“RCCA is excited to partner with Aetna on this program. It aligns with our vision of providing patient centered care close to home,” said Terrill Jordan, RCCA President & CEO. “This partnership will not only enable us to continue the delivery of high quality care through reduced side effects, but will also facilitate cost effective care based on the data Aetna will be sharing,” said Michael Ruiz de Somocurcio, RCCA Vice President of Payer and Provider Collaboration.

The model is part of a strategic direction to transition from fee-for-service medicine to value-based payment. Value-based arrangements are emerging as a solution to address rising health care costs, clinical inefficiency, duplication of services, and access to care. In value-based models, doctors and hospitals are paid for helping to keep people healthy and for improving the health of those who have chronic conditions in an evidence-based, cost-effective way.

“We understand that cancer treatment can be the hardest experience that our members will ever have to go through,” said Daniel Knecht, M.D., M.B.A., Aetna’s Head of Strategy & Planning and Interim Head of Oncology Solutions. “This oncology medical home with RCCA will help provide our members with high-quality care and an optimal patient experience.”

The operating principles of the RCCA and Aetna oncology medical home include:

  • An orientation to the whole person. A personal physician from RCCA will be responsible for providing or arranging all of a patient’s health care needs with other qualified professionals. This includes care for all stages of treatment: preventive services, acute care, chronic care, palliative care and end-of-life care.
  • Evidence-based, personalized medical care. The RCCA team will focus on making treatment decisions based on current medical evidence for each unique disease presentation, patient-specific factors and patient choice using appropriate treatments to improve quality and outcomes.
  • Coordinated and integrated care. Care will be facilitated, across all elements of the health system, to enable Aetna members to get the appropriate care when and where it is needed and wanted, in a culturally and linguistically appropriate manner.
  • Quality and safety. Quality and safety will be a focus of care, including the use of evidence-based medicine, clinical decision support tools and accountability for continuous quality improvement.
  • Enhanced access to care. Care will be available through systems such as open scheduling, expanded hours and new options for communication between Aetna members, their personal physicians and hospital staff.

The oncology medical home arrangement launched in September 2016.

About RCCA

Regional Cancer Care Associates (RCCA), one of the largest oncology physician networks in the United States, is transforming oncology care by ensuring that cancer patients have access to the highest-quality, most-comprehensive, cutting edge treatments in a compassionate and community-based setting. RCCA includes 100 cancer care specialists and is supported by 700 employees at 27 care delivery sites, providing care to more than 23,000 new patients annually and over 230,000 existing patients in New Jersey, Maryland and Washington DC. For more information visit: http://www.RCCA.com.

About Aetna

Aetna is one of the nation’s leading diversified health care benefits companies, serving an estimated 46.3 million people with information and resources to help them make better informed decisions about their health care. Aetna offers a broad range of traditional, voluntary and consumer-directed health insurance products and related services, including medical, pharmacy, dental, behavioral health, group life and disability plans, and medical management capabilities, Medicaid health care management services, workers’ compensation administrative services and health information technology products and services. Aetna’s customers include employer groups, individuals, college students, part-time and hourly workers, health plans, health care providers, governmental units, government-sponsored plans, labor groups and expatriates. For more information, see www.aetna.com and learn about how Aetna is helping to build a healthier world. @AetnaNews

 

###

What Cancer Patients Need To Know About Clinical Trials: Insights From New Jersey Hematologist /Oncologist Seth Berk

Seth Howard Berk, MD, a hematologist and medical oncologist with RCCA, reveals four facts that he shares with his patients when they ask about clinical trials.

First, a drug has been thoroughly tested well before it reaches the clinical trial stage. Pre-clinical trial testing involves looking at a drug’s effects on animals as well as human cells. This stage usually takes years of development. Also, the clinical studies have to be designed and conducted in accordance with rigorous ethical and safety criteria.

He also imparts the importance of not thinking of clinical trials as a last resort in treatment. While trials are typically suited for situations in which traditional therapy methods are not working for a patient, there is more evidence emerging of late-stage trials benefitting the patient when used early in the diagnosis process.

A myth that Dr. Berk debunks is the use of a placebo in cancer treatment. Some cancer patients are resistant to clinical trials because they fear there will be a placebo and they will suffer as a result. He says this is misinformation or something assumed from a patient’s memory of high school or college science experiments. In clinical trials, one group will be administered the trial agent while the other continues to have traditional therapy. There are rarely ever patients receiving zero care.

Lastly, Dr. Berk addresses the importance of clinical trials for cancer patients in general. Because of willing patients participating in more and more trials, doctors and patients can share in a community of knowledge and understanding, and, one day, a cure.

To read more about clinical trials, turn to “What cancer patients need to know about clinical trials: Insights from New Jersey oncologist/hematologist Seth Berk.”

RCCA: Taking Cancer Care To A Higher Level In NJ And Beyond

Edward J. Licitra, MD, PhD, board certified in internal medicine, hematology and medical oncology and chairman of the board of directors of Regional Cancer Care Associates (RCCA), shares some of his thoughts on potential models for a health care delivery reform system. Oncologists at RCCA, totaling 100 physicians, learn from each other’s best practices with the patient’s interest at the forefront. Through RCCA, patients can receive care at home instead of visiting a hospital or clinic. They have set up 27 care delivery sites, providing care to more than 23,000 new patients annually and approximately 230,000 existing patients in New Jersey, Maryland and Washington, D.C.

Another example of a successful care reform case is the Oncology Care Model (OCM) created by Medicare under the Affordable Care Act (ACA). The model questions how to best develop an integrated style of cancer care. It focuses on developing a care model for the future, using data sharing and streamlining economics for patients as well as providers. By digitizing patients’ medical histories and sharing them through hospitals and clinics, this model focuses on simplifying the oncology care process.

Lastly, the OCM utilizes evidence-based-medicine (EBM) practices throughout the entire spectrum of care. EBM produces the best methods regardless of cost, while even reducing cost by eliminating wasteful spending. The OCM focuses on patient-focused, research based therapy tailored to the individual patient.

To learn more about this topic, read “RCCA: Taking cancer care to a higher level in NJ and beyond.”

Targeting Treatments for Chronic Lymphocytic Leukemia

Dr. Joel Silver

 

How do myeloma and chronic lymphocytic leukemia (CLL) develop? What are some risk factors associated with those malignancies?

A. We don’t know what causes CLL. We do know that people in some occupations or with a certain exposure history might be at higher risk, and that CLL generally affects older people. Treatment fortunately is not needed in many cases, but even so our treatment options have evolved based on cytogenetics and next-generation sequencing. We have more ways to assess prognostic features and design more personalized and potentially more effective therapy for people with CLL.

 

What therapies have been successful in treating CLL over the last two to three years?

A. If you can identify a certain kind of CLL, such as IDH-mutated CLL, some of the patients with it can receive a standard chemotherapy regimen called FCR, and they sometimes go into remission indefinitely. It depends on whether the patient is young and healthy enough to tolerate the therapy. That’s a select group, though; you don’t see too many young people with CLL.

Years ago, an effective treatment did not exist for another group of patients with CLL, those with the genetic 17p deletion. In recent years, however, the oral agent ibrutinib has shown effectiveness for CLL in this group. Other therapies now are available for patients who don’t respond to ibrutinib.

 

Where does targeted therapy come into play?

A. In general, “targeted therapy” refers to a treatment based on a particular mutation or pattern. The presence of the genetic 17p deletion in CLL is one example, but this is a bad cytogenetic abnormality for which standard treatments such as chemotherapy haven’t worked. If we can identify a particular mutation, then we can target our therapy and plan treatment that we know will work, instead of going through chemotherapies that are only partially effective or downright ineffective and then finding that the patient is resistant to treatment.

 

Are there side effects or drawbacks to targeted therapy?

A. Everything we do has side effects. The oral agent ibrutinib has been an effective first-line therapy for any type of CLL. Although the agent is specifically for patients with 17p deletion, it has also worked for patients without that genetic feature. While some cardiovascular and bleeding issues have been reported, ibrutinib overall is more tolerable than chemotherapy.

When we medically examine patients with CLL, we always look at a pattern of mutations to try to identify how to treat these people — not so much from an immediate therapeutic standpoint, but to gain knowledge of all these other cytogenetic abnormalities so that eventually, we will find other ways to target those different patterns.

What important points do you address with patients before they begin CLL therapy?

A. Many people with CLL don’t die of their disease, they die with their disease, so I tell patients not to be afraid of the disease itself. Many of the conversations we have with these people, however, revolve around the fact that they have this problem but may never need treatment. “We should follow you because you may need treatment down the line,” I tell them. “If you need treatment, we have many effective therapies.”

 

Do you foresee different therapies for CLL emerging within the next two to three years?

A. A number of medications are on the horizon that will be appropriate for any patient with CLL. For example, venetoclax, which gained FDA approval last year, is indicated for second-line treatment of CLL in patients with the 17p deletion, but I think that agent will be effective for all patients with CLL. As similarly versatile agents are developed, we will have many more treatment options.

Colorectal Cancer Trends in Maryland: A Conversation with Dr. Ralph V. Boccia

As the third most common cancer in the United States, colorectal cancer (CRC) affects about 1 in 20 Americans. However, incidence and death rates for cancer of the colorectum have significantly decreased over the past several decades as a result of increased screening and drastic improvements in treatment. In Maryland alone, approximately 70% of adults over the age of 50 have an up-to-date colorectal cancer screening, helping contribute to the reduction in mortality rates.

Dr. Ralph V. Boccia, an oncology and hematology specialist at Regional Cancer Care Associates (RCCA) in Bethesda and Germantown, Maryland says, “The more colorectal screening we have and the earlier it gets started, the lower the stage that the cancer is typically picked up.” In turn, early detection has led to the state’s lower mortality rates over time.

 

The Benefits Of Increased Screening

According to Dr. Boccia, improving screening rates “affects the stage at which the cancer presents itself and [the patient’s] potential for survival.” Between 2002 and 2010, the percentage of Maryland adults with up-to-date colorectal cancer screenings increased from 64% to 71%. As a result, CRC mortality rates in Maryland decreased considerably among both men and women in that eight-year timeframe. Dr. Boccia explains, “The trend we’ve actually seen – which is that more people are being screened – has resulted in more improvements of overall survival in patients with colorectal cancer.”

However, as colon cancer rates decline in adults 50 years and older, both incidence and death rates are increasing in the under-50 population. “We’re seeing a scary trend of younger patients getting colorectal cancer,” remarks Dr. Boccia, “even down into the 20s.” However, at this point in time, there’s insufficient data to clearly identify the causation behind this trend.

 

Colorectal Cancer Risk Factors

According to a report from the Maryland Department of Health and Mental Hygiene, the incidence rate of colon cancer per 100,000 people in Maryland was 1,174 for men and 1,109 for women in 2012. When looking at new cases of CRC, research shows that incidence may be tied to habits and lifestyles. Among these lifestyle- associated risk factors are being overweight or obese, lack of physical activity, smoking, heavy alcohol use and certain types of diets.

As outlined by the American Cancer Society, other risk factors unrelated to lifestyle choices are personal and family histories of colorectal cancer or adenomatous polyps, having type 2 diabetes, possessing an inherited syndrome, such as Lynch Syndrome, and certain racial and ethnic backgrounds. In addition, Dr. Boccia notes that a personal history of inflammatory bowel disease may increase the risk for developing colorectal cancer. “Patients with ulcerative colitis have to be screened very frequently for colon cancer,” Dr. Boccia elucidates, “because of that high predisposition.”

 

Common CRC Treatments

“For early stage colorectal cancer, the treatment of choice is surgery,” says Dr. Boccia. In this stage, a group of abnormal cells, referred to as carcinoma in situ (CIS), can be removed by a polypectomy, or a part of the colon can be removed via a partial colectomy. Once the cancer has penetrated the wall of the colon and perhaps even grown into nearby tissue, patients of RCCA Maryland will typically undergo active surveillance – although other treatment options are offered to those with high-risk tumors, says Dr. Boccia.

Once the cancer has reached Stage III, patients are generally offered a form of chemotherapy for roughly six weeks. “FOLFOX is the adjuvant therapy of choice,” says Dr. Boccia, “and that we know will lower the incidence of recurrence by about 40-50%.” For Stage IV diseases, which make up about 20% of the cases that RCCA Maryland sees each year, chemotherapy, targeted therapy and even immunotherapy can be used to offer aggressive treatment. If they no longer respond to a particular drug, patients will be introduced to a new regimen.

In regards to new research and treatment options, Dr. Boccia concludes, “I have 50 to 60 clinical trials open at all times in the center, so we’re always looking actively for good, cutting-edge therapies and offering those to our patients.”

 

If you or someone you love has been diagnosed with colorectal cancer, schedule an appointment at one of RCCA’s 29 locations in New Jersey, Maryland or Connecticut for personalized, professional care.

Molecular Testing: Tailoring Treatment by Targeting Pathways

Phillip D. Reid, MD

 

What is molecular testing? How it is used in cancer care?

A.  As we learn how to treat specific subtypes of cancer more accurately, molecular testing, molecular medicine and molecular diagnostics are becoming more prominent in oncology.

In the past, once a cancer was diagnosed, we determined the organ where it started, how much cancer was in the body and where it was. We have since discovered many pathways through which a cancer develops. We now need to know not only the stage, type and origin of cancer, but also the pathway through which it developed and then target that pathway.

 

How does the pathway concept affect therapy selection?

A.  It enhances our ability to treat the cancer, but we now need extra testing on a patient’s particular cancer cells. The great thing about molecular testing is we get an answer specific for the individual, not just for everyone, for example, with lung cancer. But it does require more time for us to find the pathway. From the patient’s standpoint, diagnosis and stage are obtained, and then sometimes we have to send off the cancer cells for extra testing, which increases the time between diagnosis and treatment. But ultimately, a better sense is provided of what drug to use and when to use it, and there’s a much greater likelihood of devising specific, effective treatment.

 

For which types of cancer should molecular testing be used?

A.  Molecular testing has revolutionized every major cancer diagnosis. Patients with lung and breast cancer are the best candidates, but molecular testing also is useful in colon cancer, head-and-neck and bladder cancer, and some leukemias and myelomas.

 

What have been the main developments over the last two to three years with molecular testing?

A.  It’s becoming easier and more standardized to get molecular testing done. A patient receives a diagnosis and his or her cancer is sent off to a lab, which evaluates all known pathways for that cancer. A specific result is received. As the patient receives therapy, sometimes the cancer changes and he or she may need a second or third biopsy one to three years after the initial diagnosis to see what’s changed in the cancer, and then the treatment changes based on that result. We now see cancer as a moving target as it progresses, and we have to recalibrate every few years so that we’re shooting that target correctly.

 

What should patients know about molecular testing before proceeding?

A.  After a patient receives his or her staging diagnosis, the next question is, “What subtype of lung cancer do I have and what pathway did the cancer use to develop?” The patient needs to have patience, as that extra information may not arrive for two to four weeks, but that information can increase the chances of treatment success.

Also ask about clinical trials of cancer medications before beginning therapy, because we often know about upcoming medications that are effective and possibly better than what we have right now.

Colorectal Cancer Trends and Treatment

Ralph V. Boccia, MD, a cancer specialist at RCCA Maryland, provides some insight into recent colorectal cancer trends and treatments that are giving new hope to doctors, researchers and patients nationwide. Overall, Dr. Boccia finds much to be encouraged by, but also points to the need for awareness of a concerning development in the field of colorectal cancer.

 

How Far We’ve Come and Where We’re Going

As a whole, colorectal cancer rates have been dropping. According to the National Cancer Institute and Centers for Disease Control and Prevention, Maryland alone has seen a 2.6% decrease in the amount of new CRC patients diagnosed over a five-year period. Dr. Boccia believes this trend can be partly attributed to the following:

  • Widespread increase in colonoscopies and other CRC screening methods
  • Early detection and removal of polyps before they become cancerous
  • More cases being diagnosed at an early stage – when the cancer is more responsive to treatment

Despite the good news, it’s still projected that 2,358 Maryland residents will be diagnosed and that 927 people will die from the disease this year, says Dr. Boccia. Doctors have also been noticing an uncharacteristic increase in the amount of younger adults being diagnosed with CRC. Since it typically affects individuals above the age of 50, this emerging demographic has been cause for concern. But Dr. Boccia and his colleagues will continue to conduct research and make further strides in colorectal cancer care to better serve patients of all ages.

 

Current Treatment Options

Surgical innovations, targeted therapies, immunotherapies, chemotherapy and clinical trials are paving the way for more effective CRC solutions. Dr. Boccia explains, “We have a greater ability than ever before to individualize care, and to offer patients multi-modal treatment regimens that employ a variety of mechanisms of action to combat cancer by different means.”

 

Reducing Your Risk

Follow these tips to help reduce your risk for developing colorectal cancer:

  • Maintain a healthy weight
  • Stay physically active
  • Avoid smoking cigarettes and only drink alcohol in moderation
  • Get a CRC screening regularly
  • Consult a physician right away if you experience any CRC symptoms, such as blood in the stool and persistent abdominal pain
  • Manage other conditions that may increase your risk for CRC, like type 2 diabetes, inflammatory bowel disease and adenomatous polyps

 

If you or someone you love has been diagnosed with colorectal cancer, schedule an appointment at one of RCCA’s 29 locations in New Jersey, Maryland or Connecticut for personalized, professional care.

RCCA Earns URAC Accreditation In Specialty Pharmacy

[Hackensack, NJ] – RCCA is proud to announce that it has earned URAC accreditation in Specialty Pharmacy. URAC is the independent leader in promoting healthcare quality through accreditation, certification and measurement. By achieving this status, RCCA has demonstrated a comprehensive commitment to quality care, improved processes and better patient outcomes.

 

“URAC Accreditation is a testament to the commitment of delivering the highest level of quality standards to our patients and their caregivers,” said Terrill Jordan, President and CEO of RCCA. ”This type of commitment is the cornerstone of everything we do at RCCA,” he added.

Edward Licitra, MD, PhD, RCCA Chairperson of the Board and RCCA Pharmacy Medical Director and Eileen Peng, PharmD, Director of the RCCA Pharmacy agree that “this new recognition will allow us to continue to provide the highest level of patient care and convenience for the people that need it the most.”

 

“Pharmacy services have never played such an important role in the delivery of care as they do today. RCCA distinguishes itself for having voluntarily undergone a rigorous review of quality standards that earned it URAC accreditation,” said URAC President and CEO Kylanne Green. “Independent URAC accreditation shows RCCA is dedicated to quality and safety, and that it strives for a continual improvement of its services.”

ABOUT RCCA

Regional Cancer Care Associates (RCCA), one of the largest oncology physician networks in the United States, is transforming oncology care by ensuring that cancer patients have access to the highest-quality, most-comprehensive, cutting edge treatments in a compassionate and community-based setting. RCCA includes more than 100 cancer care specialists and is supported by 800 employees at more than 30 care delivery sites, providing care to more than 24,000 new patients annually and over 240,000 existing patients.  For more information visit: http://www.RCCA.com

About URAC

Founded in 1990, URAC is the independent leader in promoting healthcare quality through accreditation, certification and measurement. URAC is a nonprofit organization developing evidence-based measures and standards through inclusive engagement with a range of stakeholders committed to improving the quality of healthcare. Our portfolio of accreditation and certification programs span the healthcare industry, addressing healthcare management, healthcare operations, health plans, pharmacies, telehealth providers, physician practices, and more. URAC accreditation is a symbol of excellence for organizations to showcase their validated commitment to quality and accountability.

For further information, contact:

Mary Lou Salvemini
msalvemini@regionalcancercare.org
(201) 510-0922

RCCA Makes Innovative UnitedHealthcare Cancer Care Program Available to Patients in Maryland

HACKENSACK, N.J., Nov. 22, 2016 /PRNewswire-USNewswire/ — Regional Cancer Care Associates (RCCA) is expanding its cancer care payment initiative with UnitedHealthcare to RCCA patients in Maryland who are covered by UnitedHealthcare benefit plans.

The program, made available at RCCA New Jersey locations in January, rewards physicians for focusing on best treatment practices, quality patient care and better health outcomes. The program pays participating medical oncologists more if they demonstrate superior clinical results and if they reduce the total cost of care.

The episode payment model shifts reimbursement away from the current “fee-for-service” approach that emphasizes volume of care delivered regardless of a patient’s health outcomes. The episode payment is based on the expected cost of a standard treatment regimen for a specific condition, as predetermined by the doctor. Similar payment models have been shown to enhance care coordination and improve health outcomes for patients, while reducing overall costs.

“RCCA has emerged as a leader in delivering the highest-level quality cancer care to our patients,” said Terrill Jordan, RCCA President and CEO. “New payment methodologies like this put patients’ interests at the forefront of cancer treatment. It also results in significant cost savings, which advances efforts across the country to assist in controlling rising health care costs. We are excited to offer this program to our Maryland patient base.”

Lee N. Newcomer, M.D., UnitedHealthcare’s Senior Vice President, Oncology, said: “Our partnership with RCCA marks an important step toward expanded episode payment models and away from the traditional fee-for-service payments for oncology care. We look forward to working with RCCA and others to expand our efforts to identify best practices for treating cancer.”

A study published in the Journal of Oncology Practice has demonstrated that this program reduced overall cancer expenses by more than a third while improving quality outcomes. RCCA is among five oncology practices that have joined the program, which now has a total of more than 650 oncologists. RCCA in New Jersey and now Maryland comprise approximately 100 of these oncologists.

“Value-based cancer care is here. This program will enable Maryland-based RCCA oncologists to continue to provide patient-centered care at the highest level of quality,” said Ralph Boccia, M.D., RCCA Research Deputy Chair and Oncologist in Bethesda and Germantown, Md.

UnitedHealthcare first implemented its episode payment program as a pilot study between October 2009 and December 2012. The pilot study produced a significant reduction in hospitalizations and a 34 percent reduction in total costs while improving quality. Click here to read results of the study.

About RCCA
Regional Cancer Care Associates (RCCA), one of the largest oncology physician networks in the United States, is transforming oncology care by ensuring that cancer patients have access to the highest-quality, most-comprehensive, cutting edge treatments in a compassionate and community-based setting. RCCA includes 100 cancer care specialists and is supported by 700 employees at 27 care delivery sites, providing care to more than 230,000 existing patients in New Jersey, Maryland and Washington DC.  For more information visit: http://www.RCCA.com

Contact:

Mary Lou Salvemini
msalvemini@regionalcancercare.org
(201) 510-0922

REGIONAL CANCER CARE ASSOCIATES AND AETNA FORM ONCOLOGY MEDICAL HOME

REGIONAL CANCER CARE ASSOCIATES AND AETNA FORM ONCOLOGY MEDICAL HOME

— The Patient-Focused Model Supports High-Value Care–

 

Hackensack, NJ, October 12, 2016 — Regional Cancer Care Associates (RCCA) and Aetna (NYSE: AET) announced a collaboration to create an oncology medical home that is designed to improve the care experience for cancer patients.

In the oncology medical home model, teams of cancer specialists collectively provide a patient’s health care when he or she has a cancer diagnosis. The model will give RCCA the responsibility to arrange appropriate care that is continuous and proactive and physicians will be incentivized for improved health, affordability and a better patient experience.

The oncology medical home arrangement will be available to patients at all RCCA locations in New Jersey and Maryland.

“RCCA is excited to partner with Aetna on this program. It aligns with our vision of providing patient centered care close to home,” said Terrill Jordan, RCCA President & CEO. “This partnership will not only enable us to continue the delivery of high quality care through reduced side effects, but will also facilitate cost effective care based on the data Aetna will be sharing,” said Michael Ruiz de Somocurcio, RCCA Vice President of Payer and Provider Collaboration.

The model is part of a strategic direction to transition from fee-for-service medicine to value-based payment. Value-based arrangements are emerging as a solution to address rising health care costs, clinical inefficiency, duplication of services, and access to care. In value-based models, doctors and hospitals are paid for helping to keep people healthy and for improving the health of those who have chronic conditions in an evidence-based, cost-effective way.

“We understand that cancer treatment can be the hardest experience that our members will ever have to go through,” said Daniel Knecht, M.D., M.B.A., Aetna’s Head of Strategy & Planning and Interim Head of Oncology Solutions. “This oncology medical home with RCCA will help provide our members with high-quality care and an optimal patient experience.”

The operating principles of the RCCA and Aetna oncology medical home include:

  • An orientation to the whole person. A personal physician from RCCA will be responsible for providing or arranging all of a patient’s health care needs with other qualified professionals. This includes care for all stages of treatment: preventive services, acute care, chronic care, palliative care and end-of-life care.
  • Evidence-based, personalized medical care. The RCCA team will focus on making treatment decisions based on current medical evidence for each unique disease presentation, patient-specific factors and patient choice using appropriate treatments to improve quality and outcomes.
  • Coordinated and integrated care. Care will be facilitated, across all elements of the health system, to enable Aetna members to get the appropriate care when and where it is needed and wanted, in a culturally and linguistically appropriate manner.
  • Quality and safety. Quality and safety will be a focus of care, including the use of evidence-based medicine, clinical decision support tools and accountability for continuous quality improvement.
  • Enhanced access to care. Care will be available through systems such as open scheduling, expanded hours and new options for communication between Aetna members, their personal physicians and hospital staff.

The oncology medical home arrangement launched in September 2016.

About RCCA

Regional Cancer Care Associates (RCCA), one of the largest oncology physician networks in the United States, is transforming oncology care by ensuring that cancer patients have access to the highest-quality, most-comprehensive, cutting edge treatments in a compassionate and community-based setting. RCCA includes 100 cancer care specialists and is supported by 700 employees at 27 care delivery sites, providing care to more than 23,000 new patients annually and over 230,000 existing patients in New Jersey, Maryland and Washington DC. For more information visit: http://www.RCCA.com.

About Aetna

Aetna is one of the nation’s leading diversified health care benefits companies, serving an estimated 46.3 million people with information and resources to help them make better informed decisions about their health care. Aetna offers a broad range of traditional, voluntary and consumer-directed health insurance products and related services, including medical, pharmacy, dental, behavioral health, group life and disability plans, and medical management capabilities, Medicaid health care management services, workers’ compensation administrative services and health information technology products and services. Aetna’s customers include employer groups, individuals, college students, part-time and hourly workers, health plans, health care providers, governmental units, government-sponsored plans, labor groups and expatriates. For more information, see www.aetna.com and learn about how Aetna is helping to build a healthier world. @AetnaNews

 

###

What Cancer Patients Need To Know About Clinical Trials: Insights From New Jersey Hematologist /Oncologist Seth Berk

Seth Howard Berk, MD, a hematologist and medical oncologist with RCCA, reveals four facts that he shares with his patients when they ask about clinical trials.

First, a drug has been thoroughly tested well before it reaches the clinical trial stage. Pre-clinical trial testing involves looking at a drug’s effects on animals as well as human cells. This stage usually takes years of development. Also, the clinical studies have to be designed and conducted in accordance with rigorous ethical and safety criteria.

He also imparts the importance of not thinking of clinical trials as a last resort in treatment. While trials are typically suited for situations in which traditional therapy methods are not working for a patient, there is more evidence emerging of late-stage trials benefitting the patient when used early in the diagnosis process.

A myth that Dr. Berk debunks is the use of a placebo in cancer treatment. Some cancer patients are resistant to clinical trials because they fear there will be a placebo and they will suffer as a result. He says this is misinformation or something assumed from a patient’s memory of high school or college science experiments. In clinical trials, one group will be administered the trial agent while the other continues to have traditional therapy. There are rarely ever patients receiving zero care.

Lastly, Dr. Berk addresses the importance of clinical trials for cancer patients in general. Because of willing patients participating in more and more trials, doctors and patients can share in a community of knowledge and understanding, and, one day, a cure.

To read more about clinical trials, turn to “What cancer patients need to know about clinical trials: Insights from New Jersey oncologist/hematologist Seth Berk.”

RCCA: Taking Cancer Care To A Higher Level In NJ And Beyond

Edward J. Licitra, MD, PhD, board certified in internal medicine, hematology and medical oncology and chairman of the board of directors of Regional Cancer Care Associates (RCCA), shares some of his thoughts on potential models for a health care delivery reform system. Oncologists at RCCA, totaling 100 physicians, learn from each other’s best practices with the patient’s interest at the forefront. Through RCCA, patients can receive care at home instead of visiting a hospital or clinic. They have set up 27 care delivery sites, providing care to more than 23,000 new patients annually and approximately 230,000 existing patients in New Jersey, Maryland and Washington, D.C.

Another example of a successful care reform case is the Oncology Care Model (OCM) created by Medicare under the Affordable Care Act (ACA). The model questions how to best develop an integrated style of cancer care. It focuses on developing a care model for the future, using data sharing and streamlining economics for patients as well as providers. By digitizing patients’ medical histories and sharing them through hospitals and clinics, this model focuses on simplifying the oncology care process.

Lastly, the OCM utilizes evidence-based-medicine (EBM) practices throughout the entire spectrum of care. EBM produces the best methods regardless of cost, while even reducing cost by eliminating wasteful spending. The OCM focuses on patient-focused, research based therapy tailored to the individual patient.

To learn more about this topic, read “RCCA: Taking cancer care to a higher level in NJ and beyond.”

Targeting Treatments for Chronic Lymphocytic Leukemia

Dr. Joel Silver

 

How do myeloma and chronic lymphocytic leukemia (CLL) develop? What are some risk factors associated with those malignancies?

A. We don’t know what causes CLL. We do know that people in some occupations or with a certain exposure history might be at higher risk, and that CLL generally affects older people. Treatment fortunately is not needed in many cases, but even so our treatment options have evolved based on cytogenetics and next-generation sequencing. We have more ways to assess prognostic features and design more personalized and potentially more effective therapy for people with CLL.

 

What therapies have been successful in treating CLL over the last two to three years?

A. If you can identify a certain kind of CLL, such as IDH-mutated CLL, some of the patients with it can receive a standard chemotherapy regimen called FCR, and they sometimes go into remission indefinitely. It depends on whether the patient is young and healthy enough to tolerate the therapy. That’s a select group, though; you don’t see too many young people with CLL.

Years ago, an effective treatment did not exist for another group of patients with CLL, those with the genetic 17p deletion. In recent years, however, the oral agent ibrutinib has shown effectiveness for CLL in this group. Other therapies now are available for patients who don’t respond to ibrutinib.

 

Where does targeted therapy come into play?

A. In general, “targeted therapy” refers to a treatment based on a particular mutation or pattern. The presence of the genetic 17p deletion in CLL is one example, but this is a bad cytogenetic abnormality for which standard treatments such as chemotherapy haven’t worked. If we can identify a particular mutation, then we can target our therapy and plan treatment that we know will work, instead of going through chemotherapies that are only partially effective or downright ineffective and then finding that the patient is resistant to treatment.

 

Are there side effects or drawbacks to targeted therapy?

A. Everything we do has side effects. The oral agent ibrutinib has been an effective first-line therapy for any type of CLL. Although the agent is specifically for patients with 17p deletion, it has also worked for patients without that genetic feature. While some cardiovascular and bleeding issues have been reported, ibrutinib overall is more tolerable than chemotherapy.

When we medically examine patients with CLL, we always look at a pattern of mutations to try to identify how to treat these people — not so much from an immediate therapeutic standpoint, but to gain knowledge of all these other cytogenetic abnormalities so that eventually, we will find other ways to target those different patterns.

What important points do you address with patients before they begin CLL therapy?

A. Many people with CLL don’t die of their disease, they die with their disease, so I tell patients not to be afraid of the disease itself. Many of the conversations we have with these people, however, revolve around the fact that they have this problem but may never need treatment. “We should follow you because you may need treatment down the line,” I tell them. “If you need treatment, we have many effective therapies.”

 

Do you foresee different therapies for CLL emerging within the next two to three years?

A. A number of medications are on the horizon that will be appropriate for any patient with CLL. For example, venetoclax, which gained FDA approval last year, is indicated for second-line treatment of CLL in patients with the 17p deletion, but I think that agent will be effective for all patients with CLL. As similarly versatile agents are developed, we will have many more treatment options.

Colorectal Cancer Trends in Maryland: A Conversation with Dr. Ralph V. Boccia

As the third most common cancer in the United States, colorectal cancer (CRC) affects about 1 in 20 Americans. However, incidence and death rates for cancer of the colorectum have significantly decreased over the past several decades as a result of increased screening and drastic improvements in treatment. In Maryland alone, approximately 70% of adults over the age of 50 have an up-to-date colorectal cancer screening, helping contribute to the reduction in mortality rates.

Dr. Ralph V. Boccia, an oncology and hematology specialist at Regional Cancer Care Associates (RCCA) in Bethesda and Germantown, Maryland says, “The more colorectal screening we have and the earlier it gets started, the lower the stage that the cancer is typically picked up.” In turn, early detection has led to the state’s lower mortality rates over time.

 

The Benefits Of Increased Screening

According to Dr. Boccia, improving screening rates “affects the stage at which the cancer presents itself and [the patient’s] potential for survival.” Between 2002 and 2010, the percentage of Maryland adults with up-to-date colorectal cancer screenings increased from 64% to 71%. As a result, CRC mortality rates in Maryland decreased considerably among both men and women in that eight-year timeframe. Dr. Boccia explains, “The trend we’ve actually seen – which is that more people are being screened – has resulted in more improvements of overall survival in patients with colorectal cancer.”

However, as colon cancer rates decline in adults 50 years and older, both incidence and death rates are increasing in the under-50 population. “We’re seeing a scary trend of younger patients getting colorectal cancer,” remarks Dr. Boccia, “even down into the 20s.” However, at this point in time, there’s insufficient data to clearly identify the causation behind this trend.

 

Colorectal Cancer Risk Factors

According to a report from the Maryland Department of Health and Mental Hygiene, the incidence rate of colon cancer per 100,000 people in Maryland was 1,174 for men and 1,109 for women in 2012. When looking at new cases of CRC, research shows that incidence may be tied to habits and lifestyles. Among these lifestyle- associated risk factors are being overweight or obese, lack of physical activity, smoking, heavy alcohol use and certain types of diets.

As outlined by the American Cancer Society, other risk factors unrelated to lifestyle choices are personal and family histories of colorectal cancer or adenomatous polyps, having type 2 diabetes, possessing an inherited syndrome, such as Lynch Syndrome, and certain racial and ethnic backgrounds. In addition, Dr. Boccia notes that a personal history of inflammatory bowel disease may increase the risk for developing colorectal cancer. “Patients with ulcerative colitis have to be screened very frequently for colon cancer,” Dr. Boccia elucidates, “because of that high predisposition.”

 

Common CRC Treatments

“For early stage colorectal cancer, the treatment of choice is surgery,” says Dr. Boccia. In this stage, a group of abnormal cells, referred to as carcinoma in situ (CIS), can be removed by a polypectomy, or a part of the colon can be removed via a partial colectomy. Once the cancer has penetrated the wall of the colon and perhaps even grown into nearby tissue, patients of RCCA Maryland will typically undergo active surveillance – although other treatment options are offered to those with high-risk tumors, says Dr. Boccia.

Once the cancer has reached Stage III, patients are generally offered a form of chemotherapy for roughly six weeks. “FOLFOX is the adjuvant therapy of choice,” says Dr. Boccia, “and that we know will lower the incidence of recurrence by about 40-50%.” For Stage IV diseases, which make up about 20% of the cases that RCCA Maryland sees each year, chemotherapy, targeted therapy and even immunotherapy can be used to offer aggressive treatment. If they no longer respond to a particular drug, patients will be introduced to a new regimen.

In regards to new research and treatment options, Dr. Boccia concludes, “I have 50 to 60 clinical trials open at all times in the center, so we’re always looking actively for good, cutting-edge therapies and offering those to our patients.”

 

If you or someone you love has been diagnosed with colorectal cancer, schedule an appointment at one of RCCA’s 29 locations in New Jersey, Maryland or Connecticut for personalized, professional care.

Molecular Testing: Tailoring Treatment by Targeting Pathways

Phillip D. Reid, MD

 

What is molecular testing? How it is used in cancer care?

A.  As we learn how to treat specific subtypes of cancer more accurately, molecular testing, molecular medicine and molecular diagnostics are becoming more prominent in oncology.

In the past, once a cancer was diagnosed, we determined the organ where it started, how much cancer was in the body and where it was. We have since discovered many pathways through which a cancer develops. We now need to know not only the stage, type and origin of cancer, but also the pathway through which it developed and then target that pathway.

 

How does the pathway concept affect therapy selection?

A.  It enhances our ability to treat the cancer, but we now need extra testing on a patient’s particular cancer cells. The great thing about molecular testing is we get an answer specific for the individual, not just for everyone, for example, with lung cancer. But it does require more time for us to find the pathway. From the patient’s standpoint, diagnosis and stage are obtained, and then sometimes we have to send off the cancer cells for extra testing, which increases the time between diagnosis and treatment. But ultimately, a better sense is provided of what drug to use and when to use it, and there’s a much greater likelihood of devising specific, effective treatment.

 

For which types of cancer should molecular testing be used?

A.  Molecular testing has revolutionized every major cancer diagnosis. Patients with lung and breast cancer are the best candidates, but molecular testing also is useful in colon cancer, head-and-neck and bladder cancer, and some leukemias and myelomas.

 

What have been the main developments over the last two to three years with molecular testing?

A.  It’s becoming easier and more standardized to get molecular testing done. A patient receives a diagnosis and his or her cancer is sent off to a lab, which evaluates all known pathways for that cancer. A specific result is received. As the patient receives therapy, sometimes the cancer changes and he or she may need a second or third biopsy one to three years after the initial diagnosis to see what’s changed in the cancer, and then the treatment changes based on that result. We now see cancer as a moving target as it progresses, and we have to recalibrate every few years so that we’re shooting that target correctly.

 

What should patients know about molecular testing before proceeding?

A.  After a patient receives his or her staging diagnosis, the next question is, “What subtype of lung cancer do I have and what pathway did the cancer use to develop?” The patient needs to have patience, as that extra information may not arrive for two to four weeks, but that information can increase the chances of treatment success.

Also ask about clinical trials of cancer medications before beginning therapy, because we often know about upcoming medications that are effective and possibly better than what we have right now.

Colorectal Cancer Trends and Treatment

Ralph V. Boccia, MD, a cancer specialist at RCCA Maryland, provides some insight into recent colorectal cancer trends and treatments that are giving new hope to doctors, researchers and patients nationwide. Overall, Dr. Boccia finds much to be encouraged by, but also points to the need for awareness of a concerning development in the field of colorectal cancer.

 

How Far We’ve Come and Where We’re Going

As a whole, colorectal cancer rates have been dropping. According to the National Cancer Institute and Centers for Disease Control and Prevention, Maryland alone has seen a 2.6% decrease in the amount of new CRC patients diagnosed over a five-year period. Dr. Boccia believes this trend can be partly attributed to the following:

  • Widespread increase in colonoscopies and other CRC screening methods
  • Early detection and removal of polyps before they become cancerous
  • More cases being diagnosed at an early stage – when the cancer is more responsive to treatment

Despite the good news, it’s still projected that 2,358 Maryland residents will be diagnosed and that 927 people will die from the disease this year, says Dr. Boccia. Doctors have also been noticing an uncharacteristic increase in the amount of younger adults being diagnosed with CRC. Since it typically affects individuals above the age of 50, this emerging demographic has been cause for concern. But Dr. Boccia and his colleagues will continue to conduct research and make further strides in colorectal cancer care to better serve patients of all ages.

 

Current Treatment Options

Surgical innovations, targeted therapies, immunotherapies, chemotherapy and clinical trials are paving the way for more effective CRC solutions. Dr. Boccia explains, “We have a greater ability than ever before to individualize care, and to offer patients multi-modal treatment regimens that employ a variety of mechanisms of action to combat cancer by different means.”

 

Reducing Your Risk

Follow these tips to help reduce your risk for developing colorectal cancer:

  • Maintain a healthy weight
  • Stay physically active
  • Avoid smoking cigarettes and only drink alcohol in moderation
  • Get a CRC screening regularly
  • Consult a physician right away if you experience any CRC symptoms, such as blood in the stool and persistent abdominal pain
  • Manage other conditions that may increase your risk for CRC, like type 2 diabetes, inflammatory bowel disease and adenomatous polyps

 

If you or someone you love has been diagnosed with colorectal cancer, schedule an appointment at one of RCCA’s 29 locations in New Jersey, Maryland or Connecticut for personalized, professional care.

RCCA Earns URAC Accreditation In Specialty Pharmacy

[Hackensack, NJ] – RCCA is proud to announce that it has earned URAC accreditation in Specialty Pharmacy. URAC is the independent leader in promoting healthcare quality through accreditation, certification and measurement. By achieving this status, RCCA has demonstrated a comprehensive commitment to quality care, improved processes and better patient outcomes.

 

“URAC Accreditation is a testament to the commitment of delivering the highest level of quality standards to our patients and their caregivers,” said Terrill Jordan, President and CEO of RCCA. ”This type of commitment is the cornerstone of everything we do at RCCA,” he added.

Edward Licitra, MD, PhD, RCCA Chairperson of the Board and RCCA Pharmacy Medical Director and Eileen Peng, PharmD, Director of the RCCA Pharmacy agree that “this new recognition will allow us to continue to provide the highest level of patient care and convenience for the people that need it the most.”

 

“Pharmacy services have never played such an important role in the delivery of care as they do today. RCCA distinguishes itself for having voluntarily undergone a rigorous review of quality standards that earned it URAC accreditation,” said URAC President and CEO Kylanne Green. “Independent URAC accreditation shows RCCA is dedicated to quality and safety, and that it strives for a continual improvement of its services.”

ABOUT RCCA

Regional Cancer Care Associates (RCCA), one of the largest oncology physician networks in the United States, is transforming oncology care by ensuring that cancer patients have access to the highest-quality, most-comprehensive, cutting edge treatments in a compassionate and community-based setting. RCCA includes more than 100 cancer care specialists and is supported by 800 employees at more than 30 care delivery sites, providing care to more than 24,000 new patients annually and over 240,000 existing patients.  For more information visit: http://www.RCCA.com

About URAC

Founded in 1990, URAC is the independent leader in promoting healthcare quality through accreditation, certification and measurement. URAC is a nonprofit organization developing evidence-based measures and standards through inclusive engagement with a range of stakeholders committed to improving the quality of healthcare. Our portfolio of accreditation and certification programs span the healthcare industry, addressing healthcare management, healthcare operations, health plans, pharmacies, telehealth providers, physician practices, and more. URAC accreditation is a symbol of excellence for organizations to showcase their validated commitment to quality and accountability.

For further information, contact:

Mary Lou Salvemini
msalvemini@regionalcancercare.org
(201) 510-0922

RCCA Makes Innovative UnitedHealthcare Cancer Care Program Available to Patients in Maryland

HACKENSACK, N.J., Nov. 22, 2016 /PRNewswire-USNewswire/ — Regional Cancer Care Associates (RCCA) is expanding its cancer care payment initiative with UnitedHealthcare to RCCA patients in Maryland who are covered by UnitedHealthcare benefit plans.

The program, made available at RCCA New Jersey locations in January, rewards physicians for focusing on best treatment practices, quality patient care and better health outcomes. The program pays participating medical oncologists more if they demonstrate superior clinical results and if they reduce the total cost of care.

The episode payment model shifts reimbursement away from the current “fee-for-service” approach that emphasizes volume of care delivered regardless of a patient’s health outcomes. The episode payment is based on the expected cost of a standard treatment regimen for a specific condition, as predetermined by the doctor. Similar payment models have been shown to enhance care coordination and improve health outcomes for patients, while reducing overall costs.

“RCCA has emerged as a leader in delivering the highest-level quality cancer care to our patients,” said Terrill Jordan, RCCA President and CEO. “New payment methodologies like this put patients’ interests at the forefront of cancer treatment. It also results in significant cost savings, which advances efforts across the country to assist in controlling rising health care costs. We are excited to offer this program to our Maryland patient base.”

Lee N. Newcomer, M.D., UnitedHealthcare’s Senior Vice President, Oncology, said: “Our partnership with RCCA marks an important step toward expanded episode payment models and away from the traditional fee-for-service payments for oncology care. We look forward to working with RCCA and others to expand our efforts to identify best practices for treating cancer.”

A study published in the Journal of Oncology Practice has demonstrated that this program reduced overall cancer expenses by more than a third while improving quality outcomes. RCCA is among five oncology practices that have joined the program, which now has a total of more than 650 oncologists. RCCA in New Jersey and now Maryland comprise approximately 100 of these oncologists.

“Value-based cancer care is here. This program will enable Maryland-based RCCA oncologists to continue to provide patient-centered care at the highest level of quality,” said Ralph Boccia, M.D., RCCA Research Deputy Chair and Oncologist in Bethesda and Germantown, Md.

UnitedHealthcare first implemented its episode payment program as a pilot study between October 2009 and December 2012. The pilot study produced a significant reduction in hospitalizations and a 34 percent reduction in total costs while improving quality. Click here to read results of the study.

About RCCA
Regional Cancer Care Associates (RCCA), one of the largest oncology physician networks in the United States, is transforming oncology care by ensuring that cancer patients have access to the highest-quality, most-comprehensive, cutting edge treatments in a compassionate and community-based setting. RCCA includes 100 cancer care specialists and is supported by 700 employees at 27 care delivery sites, providing care to more than 230,000 existing patients in New Jersey, Maryland and Washington DC.  For more information visit: http://www.RCCA.com

Contact:

Mary Lou Salvemini
msalvemini@regionalcancercare.org
(201) 510-0922

REGIONAL CANCER CARE ASSOCIATES AND AETNA FORM ONCOLOGY MEDICAL HOME

REGIONAL CANCER CARE ASSOCIATES AND AETNA FORM ONCOLOGY MEDICAL HOME

— The Patient-Focused Model Supports High-Value Care–

 

Hackensack, NJ, October 12, 2016 — Regional Cancer Care Associates (RCCA) and Aetna (NYSE: AET) announced a collaboration to create an oncology medical home that is designed to improve the care experience for cancer patients.

In the oncology medical home model, teams of cancer specialists collectively provide a patient’s health care when he or she has a cancer diagnosis. The model will give RCCA the responsibility to arrange appropriate care that is continuous and proactive and physicians will be incentivized for improved health, affordability and a better patient experience.

The oncology medical home arrangement will be available to patients at all RCCA locations in New Jersey and Maryland.

“RCCA is excited to partner with Aetna on this program. It aligns with our vision of providing patient centered care close to home,” said Terrill Jordan, RCCA President & CEO. “This partnership will not only enable us to continue the delivery of high quality care through reduced side effects, but will also facilitate cost effective care based on the data Aetna will be sharing,” said Michael Ruiz de Somocurcio, RCCA Vice President of Payer and Provider Collaboration.

The model is part of a strategic direction to transition from fee-for-service medicine to value-based payment. Value-based arrangements are emerging as a solution to address rising health care costs, clinical inefficiency, duplication of services, and access to care. In value-based models, doctors and hospitals are paid for helping to keep people healthy and for improving the health of those who have chronic conditions in an evidence-based, cost-effective way.

“We understand that cancer treatment can be the hardest experience that our members will ever have to go through,” said Daniel Knecht, M.D., M.B.A., Aetna’s Head of Strategy & Planning and Interim Head of Oncology Solutions. “This oncology medical home with RCCA will help provide our members with high-quality care and an optimal patient experience.”

The operating principles of the RCCA and Aetna oncology medical home include:

  • An orientation to the whole person. A personal physician from RCCA will be responsible for providing or arranging all of a patient’s health care needs with other qualified professionals. This includes care for all stages of treatment: preventive services, acute care, chronic care, palliative care and end-of-life care.
  • Evidence-based, personalized medical care. The RCCA team will focus on making treatment decisions based on current medical evidence for each unique disease presentation, patient-specific factors and patient choice using appropriate treatments to improve quality and outcomes.
  • Coordinated and integrated care. Care will be facilitated, across all elements of the health system, to enable Aetna members to get the appropriate care when and where it is needed and wanted, in a culturally and linguistically appropriate manner.
  • Quality and safety. Quality and safety will be a focus of care, including the use of evidence-based medicine, clinical decision support tools and accountability for continuous quality improvement.
  • Enhanced access to care. Care will be available through systems such as open scheduling, expanded hours and new options for communication between Aetna members, their personal physicians and hospital staff.

The oncology medical home arrangement launched in September 2016.

About RCCA

Regional Cancer Care Associates (RCCA), one of the largest oncology physician networks in the United States, is transforming oncology care by ensuring that cancer patients have access to the highest-quality, most-comprehensive, cutting edge treatments in a compassionate and community-based setting. RCCA includes 100 cancer care specialists and is supported by 700 employees at 27 care delivery sites, providing care to more than 23,000 new patients annually and over 230,000 existing patients in New Jersey, Maryland and Washington DC. For more information visit: http://www.RCCA.com.

About Aetna

Aetna is one of the nation’s leading diversified health care benefits companies, serving an estimated 46.3 million people with information and resources to help them make better informed decisions about their health care. Aetna offers a broad range of traditional, voluntary and consumer-directed health insurance products and related services, including medical, pharmacy, dental, behavioral health, group life and disability plans, and medical management capabilities, Medicaid health care management services, workers’ compensation administrative services and health information technology products and services. Aetna’s customers include employer groups, individuals, college students, part-time and hourly workers, health plans, health care providers, governmental units, government-sponsored plans, labor groups and expatriates. For more information, see www.aetna.com and learn about how Aetna is helping to build a healthier world. @AetnaNews

 

###

What Cancer Patients Need To Know About Clinical Trials: Insights From New Jersey Hematologist /Oncologist Seth Berk

Seth Howard Berk, MD, a hematologist and medical oncologist with RCCA, reveals four facts that he shares with his patients when they ask about clinical trials.

First, a drug has been thoroughly tested well before it reaches the clinical trial stage. Pre-clinical trial testing involves looking at a drug’s effects on animals as well as human cells. This stage usually takes years of development. Also, the clinical studies have to be designed and conducted in accordance with rigorous ethical and safety criteria.

He also imparts the importance of not thinking of clinical trials as a last resort in treatment. While trials are typically suited for situations in which traditional therapy methods are not working for a patient, there is more evidence emerging of late-stage trials benefitting the patient when used early in the diagnosis process.

A myth that Dr. Berk debunks is the use of a placebo in cancer treatment. Some cancer patients are resistant to clinical trials because they fear there will be a placebo and they will suffer as a result. He says this is misinformation or something assumed from a patient’s memory of high school or college science experiments. In clinical trials, one group will be administered the trial agent while the other continues to have traditional therapy. There are rarely ever patients receiving zero care.

Lastly, Dr. Berk addresses the importance of clinical trials for cancer patients in general. Because of willing patients participating in more and more trials, doctors and patients can share in a community of knowledge and understanding, and, one day, a cure.

To read more about clinical trials, turn to “What cancer patients need to know about clinical trials: Insights from New Jersey oncologist/hematologist Seth Berk.”

RCCA: Taking Cancer Care To A Higher Level In NJ And Beyond

Edward J. Licitra, MD, PhD, board certified in internal medicine, hematology and medical oncology and chairman of the board of directors of Regional Cancer Care Associates (RCCA), shares some of his thoughts on potential models for a health care delivery reform system. Oncologists at RCCA, totaling 100 physicians, learn from each other’s best practices with the patient’s interest at the forefront. Through RCCA, patients can receive care at home instead of visiting a hospital or clinic. They have set up 27 care delivery sites, providing care to more than 23,000 new patients annually and approximately 230,000 existing patients in New Jersey, Maryland and Washington, D.C.

Another example of a successful care reform case is the Oncology Care Model (OCM) created by Medicare under the Affordable Care Act (ACA). The model questions how to best develop an integrated style of cancer care. It focuses on developing a care model for the future, using data sharing and streamlining economics for patients as well as providers. By digitizing patients’ medical histories and sharing them through hospitals and clinics, this model focuses on simplifying the oncology care process.

Lastly, the OCM utilizes evidence-based-medicine (EBM) practices throughout the entire spectrum of care. EBM produces the best methods regardless of cost, while even reducing cost by eliminating wasteful spending. The OCM focuses on patient-focused, research based therapy tailored to the individual patient.

To learn more about this topic, read “RCCA: Taking cancer care to a higher level in NJ and beyond.”

Targeting Treatments for Chronic Lymphocytic Leukemia

Dr. Joel Silver

 

How do myeloma and chronic lymphocytic leukemia (CLL) develop? What are some risk factors associated with those malignancies?

A. We don’t know what causes CLL. We do know that people in some occupations or with a certain exposure history might be at higher risk, and that CLL generally affects older people. Treatment fortunately is not needed in many cases, but even so our treatment options have evolved based on cytogenetics and next-generation sequencing. We have more ways to assess prognostic features and design more personalized and potentially more effective therapy for people with CLL.

 

What therapies have been successful in treating CLL over the last two to three years?

A. If you can identify a certain kind of CLL, such as IDH-mutated CLL, some of the patients with it can receive a standard chemotherapy regimen called FCR, and they sometimes go into remission indefinitely. It depends on whether the patient is young and healthy enough to tolerate the therapy. That’s a select group, though; you don’t see too many young people with CLL.

Years ago, an effective treatment did not exist for another group of patients with CLL, those with the genetic 17p deletion. In recent years, however, the oral agent ibrutinib has shown effectiveness for CLL in this group. Other therapies now are available for patients who don’t respond to ibrutinib.

 

Where does targeted therapy come into play?

A. In general, “targeted therapy” refers to a treatment based on a particular mutation or pattern. The presence of the genetic 17p deletion in CLL is one example, but this is a bad cytogenetic abnormality for which standard treatments such as chemotherapy haven’t worked. If we can identify a particular mutation, then we can target our therapy and plan treatment that we know will work, instead of going through chemotherapies that are only partially effective or downright ineffective and then finding that the patient is resistant to treatment.

 

Are there side effects or drawbacks to targeted therapy?

A. Everything we do has side effects. The oral agent ibrutinib has been an effective first-line therapy for any type of CLL. Although the agent is specifically for patients with 17p deletion, it has also worked for patients without that genetic feature. While some cardiovascular and bleeding issues have been reported, ibrutinib overall is more tolerable than chemotherapy.

When we medically examine patients with CLL, we always look at a pattern of mutations to try to identify how to treat these people — not so much from an immediate therapeutic standpoint, but to gain knowledge of all these other cytogenetic abnormalities so that eventually, we will find other ways to target those different patterns.

What important points do you address with patients before they begin CLL therapy?

A. Many people with CLL don’t die of their disease, they die with their disease, so I tell patients not to be afraid of the disease itself. Many of the conversations we have with these people, however, revolve around the fact that they have this problem but may never need treatment. “We should follow you because you may need treatment down the line,” I tell them. “If you need treatment, we have many effective therapies.”

 

Do you foresee different therapies for CLL emerging within the next two to three years?

A. A number of medications are on the horizon that will be appropriate for any patient with CLL. For example, venetoclax, which gained FDA approval last year, is indicated for second-line treatment of CLL in patients with the 17p deletion, but I think that agent will be effective for all patients with CLL. As similarly versatile agents are developed, we will have many more treatment options.

Colorectal Cancer Trends in Maryland: A Conversation with Dr. Ralph V. Boccia

As the third most common cancer in the United States, colorectal cancer (CRC) affects about 1 in 20 Americans. However, incidence and death rates for cancer of the colorectum have significantly decreased over the past several decades as a result of increased screening and drastic improvements in treatment. In Maryland alone, approximately 70% of adults over the age of 50 have an up-to-date colorectal cancer screening, helping contribute to the reduction in mortality rates.

Dr. Ralph V. Boccia, an oncology and hematology specialist at Regional Cancer Care Associates (RCCA) in Bethesda and Germantown, Maryland says, “The more colorectal screening we have and the earlier it gets started, the lower the stage that the cancer is typically picked up.” In turn, early detection has led to the state’s lower mortality rates over time.

 

The Benefits Of Increased Screening

According to Dr. Boccia, improving screening rates “affects the stage at which the cancer presents itself and [the patient’s] potential for survival.” Between 2002 and 2010, the percentage of Maryland adults with up-to-date colorectal cancer screenings increased from 64% to 71%. As a result, CRC mortality rates in Maryland decreased considerably among both men and women in that eight-year timeframe. Dr. Boccia explains, “The trend we’ve actually seen – which is that more people are being screened – has resulted in more improvements of overall survival in patients with colorectal cancer.”

However, as colon cancer rates decline in adults 50 years and older, both incidence and death rates are increasing in the under-50 population. “We’re seeing a scary trend of younger patients getting colorectal cancer,” remarks Dr. Boccia, “even down into the 20s.” However, at this point in time, there’s insufficient data to clearly identify the causation behind this trend.

 

Colorectal Cancer Risk Factors

According to a report from the Maryland Department of Health and Mental Hygiene, the incidence rate of colon cancer per 100,000 people in Maryland was 1,174 for men and 1,109 for women in 2012. When looking at new cases of CRC, research shows that incidence may be tied to habits and lifestyles. Among these lifestyle- associated risk factors are being overweight or obese, lack of physical activity, smoking, heavy alcohol use and certain types of diets.

As outlined by the American Cancer Society, other risk factors unrelated to lifestyle choices are personal and family histories of colorectal cancer or adenomatous polyps, having type 2 diabetes, possessing an inherited syndrome, such as Lynch Syndrome, and certain racial and ethnic backgrounds. In addition, Dr. Boccia notes that a personal history of inflammatory bowel disease may increase the risk for developing colorectal cancer. “Patients with ulcerative colitis have to be screened very frequently for colon cancer,” Dr. Boccia elucidates, “because of that high predisposition.”

 

Common CRC Treatments

“For early stage colorectal cancer, the treatment of choice is surgery,” says Dr. Boccia. In this stage, a group of abnormal cells, referred to as carcinoma in situ (CIS), can be removed by a polypectomy, or a part of the colon can be removed via a partial colectomy. Once the cancer has penetrated the wall of the colon and perhaps even grown into nearby tissue, patients of RCCA Maryland will typically undergo active surveillance – although other treatment options are offered to those with high-risk tumors, says Dr. Boccia.

Once the cancer has reached Stage III, patients are generally offered a form of chemotherapy for roughly six weeks. “FOLFOX is the adjuvant therapy of choice,” says Dr. Boccia, “and that we know will lower the incidence of recurrence by about 40-50%.” For Stage IV diseases, which make up about 20% of the cases that RCCA Maryland sees each year, chemotherapy, targeted therapy and even immunotherapy can be used to offer aggressive treatment. If they no longer respond to a particular drug, patients will be introduced to a new regimen.

In regards to new research and treatment options, Dr. Boccia concludes, “I have 50 to 60 clinical trials open at all times in the center, so we’re always looking actively for good, cutting-edge therapies and offering those to our patients.”

 

If you or someone you love has been diagnosed with colorectal cancer, schedule an appointment at one of RCCA’s 29 locations in New Jersey, Maryland or Connecticut for personalized, professional care.

Molecular Testing: Tailoring Treatment by Targeting Pathways

Phillip D. Reid, MD

 

What is molecular testing? How it is used in cancer care?

A.  As we learn how to treat specific subtypes of cancer more accurately, molecular testing, molecular medicine and molecular diagnostics are becoming more prominent in oncology.

In the past, once a cancer was diagnosed, we determined the organ where it started, how much cancer was in the body and where it was. We have since discovered many pathways through which a cancer develops. We now need to know not only the stage, type and origin of cancer, but also the pathway through which it developed and then target that pathway.

 

How does the pathway concept affect therapy selection?

A.  It enhances our ability to treat the cancer, but we now need extra testing on a patient’s particular cancer cells. The great thing about molecular testing is we get an answer specific for the individual, not just for everyone, for example, with lung cancer. But it does require more time for us to find the pathway. From the patient’s standpoint, diagnosis and stage are obtained, and then sometimes we have to send off the cancer cells for extra testing, which increases the time between diagnosis and treatment. But ultimately, a better sense is provided of what drug to use and when to use it, and there’s a much greater likelihood of devising specific, effective treatment.

 

For which types of cancer should molecular testing be used?

A.  Molecular testing has revolutionized every major cancer diagnosis. Patients with lung and breast cancer are the best candidates, but molecular testing also is useful in colon cancer, head-and-neck and bladder cancer, and some leukemias and myelomas.

 

What have been the main developments over the last two to three years with molecular testing?

A.  It’s becoming easier and more standardized to get molecular testing done. A patient receives a diagnosis and his or her cancer is sent off to a lab, which evaluates all known pathways for that cancer. A specific result is received. As the patient receives therapy, sometimes the cancer changes and he or she may need a second or third biopsy one to three years after the initial diagnosis to see what’s changed in the cancer, and then the treatment changes based on that result. We now see cancer as a moving target as it progresses, and we have to recalibrate every few years so that we’re shooting that target correctly.

 

What should patients know about molecular testing before proceeding?

A.  After a patient receives his or her staging diagnosis, the next question is, “What subtype of lung cancer do I have and what pathway did the cancer use to develop?” The patient needs to have patience, as that extra information may not arrive for two to four weeks, but that information can increase the chances of treatment success.

Also ask about clinical trials of cancer medications before beginning therapy, because we often know about upcoming medications that are effective and possibly better than what we have right now.

Colorectal Cancer Trends and Treatment

Ralph V. Boccia, MD, a cancer specialist at RCCA Maryland, provides some insight into recent colorectal cancer trends and treatments that are giving new hope to doctors, researchers and patients nationwide. Overall, Dr. Boccia finds much to be encouraged by, but also points to the need for awareness of a concerning development in the field of colorectal cancer.

 

How Far We’ve Come and Where We’re Going

As a whole, colorectal cancer rates have been dropping. According to the National Cancer Institute and Centers for Disease Control and Prevention, Maryland alone has seen a 2.6% decrease in the amount of new CRC patients diagnosed over a five-year period. Dr. Boccia believes this trend can be partly attributed to the following:

  • Widespread increase in colonoscopies and other CRC screening methods
  • Early detection and removal of polyps before they become cancerous
  • More cases being diagnosed at an early stage – when the cancer is more responsive to treatment

Despite the good news, it’s still projected that 2,358 Maryland residents will be diagnosed and that 927 people will die from the disease this year, says Dr. Boccia. Doctors have also been noticing an uncharacteristic increase in the amount of younger adults being diagnosed with CRC. Since it typically affects individuals above the age of 50, this emerging demographic has been cause for concern. But Dr. Boccia and his colleagues will continue to conduct research and make further strides in colorectal cancer care to better serve patients of all ages.

 

Current Treatment Options

Surgical innovations, targeted therapies, immunotherapies, chemotherapy and clinical trials are paving the way for more effective CRC solutions. Dr. Boccia explains, “We have a greater ability than ever before to individualize care, and to offer patients multi-modal treatment regimens that employ a variety of mechanisms of action to combat cancer by different means.”

 

Reducing Your Risk

Follow these tips to help reduce your risk for developing colorectal cancer:

  • Maintain a healthy weight
  • Stay physically active
  • Avoid smoking cigarettes and only drink alcohol in moderation
  • Get a CRC screening regularly
  • Consult a physician right away if you experience any CRC symptoms, such as blood in the stool and persistent abdominal pain
  • Manage other conditions that may increase your risk for CRC, like type 2 diabetes, inflammatory bowel disease and adenomatous polyps

 

If you or someone you love has been diagnosed with colorectal cancer, schedule an appointment at one of RCCA’s 29 locations in New Jersey, Maryland or Connecticut for personalized, professional care.

RCCA Earns URAC Accreditation In Specialty Pharmacy

[Hackensack, NJ] – RCCA is proud to announce that it has earned URAC accreditation in Specialty Pharmacy. URAC is the independent leader in promoting healthcare quality through accreditation, certification and measurement. By achieving this status, RCCA has demonstrated a comprehensive commitment to quality care, improved processes and better patient outcomes.

 

“URAC Accreditation is a testament to the commitment of delivering the highest level of quality standards to our patients and their caregivers,” said Terrill Jordan, President and CEO of RCCA. ”This type of commitment is the cornerstone of everything we do at RCCA,” he added.

Edward Licitra, MD, PhD, RCCA Chairperson of the Board and RCCA Pharmacy Medical Director and Eileen Peng, PharmD, Director of the RCCA Pharmacy agree that “this new recognition will allow us to continue to provide the highest level of patient care and convenience for the people that need it the most.”

 

“Pharmacy services have never played such an important role in the delivery of care as they do today. RCCA distinguishes itself for having voluntarily undergone a rigorous review of quality standards that earned it URAC accreditation,” said URAC President and CEO Kylanne Green. “Independent URAC accreditation shows RCCA is dedicated to quality and safety, and that it strives for a continual improvement of its services.”

ABOUT RCCA

Regional Cancer Care Associates (RCCA), one of the largest oncology physician networks in the United States, is transforming oncology care by ensuring that cancer patients have access to the highest-quality, most-comprehensive, cutting edge treatments in a compassionate and community-based setting. RCCA includes more than 100 cancer care specialists and is supported by 800 employees at more than 30 care delivery sites, providing care to more than 24,000 new patients annually and over 240,000 existing patients.  For more information visit: http://www.RCCA.com

About URAC

Founded in 1990, URAC is the independent leader in promoting healthcare quality through accreditation, certification and measurement. URAC is a nonprofit organization developing evidence-based measures and standards through inclusive engagement with a range of stakeholders committed to improving the quality of healthcare. Our portfolio of accreditation and certification programs span the healthcare industry, addressing healthcare management, healthcare operations, health plans, pharmacies, telehealth providers, physician practices, and more. URAC accreditation is a symbol of excellence for organizations to showcase their validated commitment to quality and accountability.

For further information, contact:

Mary Lou Salvemini
msalvemini@regionalcancercare.org
(201) 510-0922

RCCA Makes Innovative UnitedHealthcare Cancer Care Program Available to Patients in Maryland

HACKENSACK, N.J., Nov. 22, 2016 /PRNewswire-USNewswire/ — Regional Cancer Care Associates (RCCA) is expanding its cancer care payment initiative with UnitedHealthcare to RCCA patients in Maryland who are covered by UnitedHealthcare benefit plans.

The program, made available at RCCA New Jersey locations in January, rewards physicians for focusing on best treatment practices, quality patient care and better health outcomes. The program pays participating medical oncologists more if they demonstrate superior clinical results and if they reduce the total cost of care.

The episode payment model shifts reimbursement away from the current “fee-for-service” approach that emphasizes volume of care delivered regardless of a patient’s health outcomes. The episode payment is based on the expected cost of a standard treatment regimen for a specific condition, as predetermined by the doctor. Similar payment models have been shown to enhance care coordination and improve health outcomes for patients, while reducing overall costs.

“RCCA has emerged as a leader in delivering the highest-level quality cancer care to our patients,” said Terrill Jordan, RCCA President and CEO. “New payment methodologies like this put patients’ interests at the forefront of cancer treatment. It also results in significant cost savings, which advances efforts across the country to assist in controlling rising health care costs. We are excited to offer this program to our Maryland patient base.”

Lee N. Newcomer, M.D., UnitedHealthcare’s Senior Vice President, Oncology, said: “Our partnership with RCCA marks an important step toward expanded episode payment models and away from the traditional fee-for-service payments for oncology care. We look forward to working with RCCA and others to expand our efforts to identify best practices for treating cancer.”

A study published in the Journal of Oncology Practice has demonstrated that this program reduced overall cancer expenses by more than a third while improving quality outcomes. RCCA is among five oncology practices that have joined the program, which now has a total of more than 650 oncologists. RCCA in New Jersey and now Maryland comprise approximately 100 of these oncologists.

“Value-based cancer care is here. This program will enable Maryland-based RCCA oncologists to continue to provide patient-centered care at the highest level of quality,” said Ralph Boccia, M.D., RCCA Research Deputy Chair and Oncologist in Bethesda and Germantown, Md.

UnitedHealthcare first implemented its episode payment program as a pilot study between October 2009 and December 2012. The pilot study produced a significant reduction in hospitalizations and a 34 percent reduction in total costs while improving quality. Click here to read results of the study.

About RCCA
Regional Cancer Care Associates (RCCA), one of the largest oncology physician networks in the United States, is transforming oncology care by ensuring that cancer patients have access to the highest-quality, most-comprehensive, cutting edge treatments in a compassionate and community-based setting. RCCA includes 100 cancer care specialists and is supported by 700 employees at 27 care delivery sites, providing care to more than 230,000 existing patients in New Jersey, Maryland and Washington DC.  For more information visit: http://www.RCCA.com

Contact:

Mary Lou Salvemini
msalvemini@regionalcancercare.org
(201) 510-0922

REGIONAL CANCER CARE ASSOCIATES AND AETNA FORM ONCOLOGY MEDICAL HOME

REGIONAL CANCER CARE ASSOCIATES AND AETNA FORM ONCOLOGY MEDICAL HOME

— The Patient-Focused Model Supports High-Value Care–

 

Hackensack, NJ, October 12, 2016 — Regional Cancer Care Associates (RCCA) and Aetna (NYSE: AET) announced a collaboration to create an oncology medical home that is designed to improve the care experience for cancer patients.

In the oncology medical home model, teams of cancer specialists collectively provide a patient’s health care when he or she has a cancer diagnosis. The model will give RCCA the responsibility to arrange appropriate care that is continuous and proactive and physicians will be incentivized for improved health, affordability and a better patient experience.

The oncology medical home arrangement will be available to patients at all RCCA locations in New Jersey and Maryland.

“RCCA is excited to partner with Aetna on this program. It aligns with our vision of providing patient centered care close to home,” said Terrill Jordan, RCCA President & CEO. “This partnership will not only enable us to continue the delivery of high quality care through reduced side effects, but will also facilitate cost effective care based on the data Aetna will be sharing,” said Michael Ruiz de Somocurcio, RCCA Vice President of Payer and Provider Collaboration.

The model is part of a strategic direction to transition from fee-for-service medicine to value-based payment. Value-based arrangements are emerging as a solution to address rising health care costs, clinical inefficiency, duplication of services, and access to care. In value-based models, doctors and hospitals are paid for helping to keep people healthy and for improving the health of those who have chronic conditions in an evidence-based, cost-effective way.

“We understand that cancer treatment can be the hardest experience that our members will ever have to go through,” said Daniel Knecht, M.D., M.B.A., Aetna’s Head of Strategy & Planning and Interim Head of Oncology Solutions. “This oncology medical home with RCCA will help provide our members with high-quality care and an optimal patient experience.”

The operating principles of the RCCA and Aetna oncology medical home include:

  • An orientation to the whole person. A personal physician from RCCA will be responsible for providing or arranging all of a patient’s health care needs with other qualified professionals. This includes care for all stages of treatment: preventive services, acute care, chronic care, palliative care and end-of-life care.
  • Evidence-based, personalized medical care. The RCCA team will focus on making treatment decisions based on current medical evidence for each unique disease presentation, patient-specific factors and patient choice using appropriate treatments to improve quality and outcomes.
  • Coordinated and integrated care. Care will be facilitated, across all elements of the health system, to enable Aetna members to get the appropriate care when and where it is needed and wanted, in a culturally and linguistically appropriate manner.
  • Quality and safety. Quality and safety will be a focus of care, including the use of evidence-based medicine, clinical decision support tools and accountability for continuous quality improvement.
  • Enhanced access to care. Care will be available through systems such as open scheduling, expanded hours and new options for communication between Aetna members, their personal physicians and hospital staff.

The oncology medical home arrangement launched in September 2016.

About RCCA

Regional Cancer Care Associates (RCCA), one of the largest oncology physician networks in the United States, is transforming oncology care by ensuring that cancer patients have access to the highest-quality, most-comprehensive, cutting edge treatments in a compassionate and community-based setting. RCCA includes 100 cancer care specialists and is supported by 700 employees at 27 care delivery sites, providing care to more than 23,000 new patients annually and over 230,000 existing patients in New Jersey, Maryland and Washington DC. For more information visit: http://www.RCCA.com.

About Aetna

Aetna is one of the nation’s leading diversified health care benefits companies, serving an estimated 46.3 million people with information and resources to help them make better informed decisions about their health care. Aetna offers a broad range of traditional, voluntary and consumer-directed health insurance products and related services, including medical, pharmacy, dental, behavioral health, group life and disability plans, and medical management capabilities, Medicaid health care management services, workers’ compensation administrative services and health information technology products and services. Aetna’s customers include employer groups, individuals, college students, part-time and hourly workers, health plans, health care providers, governmental units, government-sponsored plans, labor groups and expatriates. For more information, see www.aetna.com and learn about how Aetna is helping to build a healthier world. @AetnaNews

 

###

What Cancer Patients Need To Know About Clinical Trials: Insights From New Jersey Hematologist /Oncologist Seth Berk

Seth Howard Berk, MD, a hematologist and medical oncologist with RCCA, reveals four facts that he shares with his patients when they ask about clinical trials.

First, a drug has been thoroughly tested well before it reaches the clinical trial stage. Pre-clinical trial testing involves looking at a drug’s effects on animals as well as human cells. This stage usually takes years of development. Also, the clinical studies have to be designed and conducted in accordance with rigorous ethical and safety criteria.

He also imparts the importance of not thinking of clinical trials as a last resort in treatment. While trials are typically suited for situations in which traditional therapy methods are not working for a patient, there is more evidence emerging of late-stage trials benefitting the patient when used early in the diagnosis process.

A myth that Dr. Berk debunks is the use of a placebo in cancer treatment. Some cancer patients are resistant to clinical trials because they fear there will be a placebo and they will suffer as a result. He says this is misinformation or something assumed from a patient’s memory of high school or college science experiments. In clinical trials, one group will be administered the trial agent while the other continues to have traditional therapy. There are rarely ever patients receiving zero care.

Lastly, Dr. Berk addresses the importance of clinical trials for cancer patients in general. Because of willing patients participating in more and more trials, doctors and patients can share in a community of knowledge and understanding, and, one day, a cure.

To read more about clinical trials, turn to “What cancer patients need to know about clinical trials: Insights from New Jersey oncologist/hematologist Seth Berk.”

RCCA: Taking Cancer Care To A Higher Level In NJ And Beyond

Edward J. Licitra, MD, PhD, board certified in internal medicine, hematology and medical oncology and chairman of the board of directors of Regional Cancer Care Associates (RCCA), shares some of his thoughts on potential models for a health care delivery reform system. Oncologists at RCCA, totaling 100 physicians, learn from each other’s best practices with the patient’s interest at the forefront. Through RCCA, patients can receive care at home instead of visiting a hospital or clinic. They have set up 27 care delivery sites, providing care to more than 23,000 new patients annually and approximately 230,000 existing patients in New Jersey, Maryland and Washington, D.C.

Another example of a successful care reform case is the Oncology Care Model (OCM) created by Medicare under the Affordable Care Act (ACA). The model questions how to best develop an integrated style of cancer care. It focuses on developing a care model for the future, using data sharing and streamlining economics for patients as well as providers. By digitizing patients’ medical histories and sharing them through hospitals and clinics, this model focuses on simplifying the oncology care process.

Lastly, the OCM utilizes evidence-based-medicine (EBM) practices throughout the entire spectrum of care. EBM produces the best methods regardless of cost, while even reducing cost by eliminating wasteful spending. The OCM focuses on patient-focused, research based therapy tailored to the individual patient.

To learn more about this topic, read “RCCA: Taking cancer care to a higher level in NJ and beyond.”

Targeting Treatments for Chronic Lymphocytic Leukemia

Dr. Joel Silver

 

How do myeloma and chronic lymphocytic leukemia (CLL) develop? What are some risk factors associated with those malignancies?

A. We don’t know what causes CLL. We do know that people in some occupations or with a certain exposure history might be at higher risk, and that CLL generally affects older people. Treatment fortunately is not needed in many cases, but even so our treatment options have evolved based on cytogenetics and next-generation sequencing. We have more ways to assess prognostic features and design more personalized and potentially more effective therapy for people with CLL.

 

What therapies have been successful in treating CLL over the last two to three years?

A. If you can identify a certain kind of CLL, such as IDH-mutated CLL, some of the patients with it can receive a standard chemotherapy regimen called FCR, and they sometimes go into remission indefinitely. It depends on whether the patient is young and healthy enough to tolerate the therapy. That’s a select group, though; you don’t see too many young people with CLL.

Years ago, an effective treatment did not exist for another group of patients with CLL, those with the genetic 17p deletion. In recent years, however, the oral agent ibrutinib has shown effectiveness for CLL in this group. Other therapies now are available for patients who don’t respond to ibrutinib.

 

Where does targeted therapy come into play?

A. In general, “targeted therapy” refers to a treatment based on a particular mutation or pattern. The presence of the genetic 17p deletion in CLL is one example, but this is a bad cytogenetic abnormality for which standard treatments such as chemotherapy haven’t worked. If we can identify a particular mutation, then we can target our therapy and plan treatment that we know will work, instead of going through chemotherapies that are only partially effective or downright ineffective and then finding that the patient is resistant to treatment.

 

Are there side effects or drawbacks to targeted therapy?

A. Everything we do has side effects. The oral agent ibrutinib has been an effective first-line therapy for any type of CLL. Although the agent is specifically for patients with 17p deletion, it has also worked for patients without that genetic feature. While some cardiovascular and bleeding issues have been reported, ibrutinib overall is more tolerable than chemotherapy.

When we medically examine patients with CLL, we always look at a pattern of mutations to try to identify how to treat these people — not so much from an immediate therapeutic standpoint, but to gain knowledge of all these other cytogenetic abnormalities so that eventually, we will find other ways to target those different patterns.

What important points do you address with patients before they begin CLL therapy?

A. Many people with CLL don’t die of their disease, they die with their disease, so I tell patients not to be afraid of the disease itself. Many of the conversations we have with these people, however, revolve around the fact that they have this problem but may never need treatment. “We should follow you because you may need treatment down the line,” I tell them. “If you need treatment, we have many effective therapies.”

 

Do you foresee different therapies for CLL emerging within the next two to three years?

A. A number of medications are on the horizon that will be appropriate for any patient with CLL. For example, venetoclax, which gained FDA approval last year, is indicated for second-line treatment of CLL in patients with the 17p deletion, but I think that agent will be effective for all patients with CLL. As similarly versatile agents are developed, we will have many more treatment options.

Colorectal Cancer Trends in Maryland: A Conversation with Dr. Ralph V. Boccia

As the third most common cancer in the United States, colorectal cancer (CRC) affects about 1 in 20 Americans. However, incidence and death rates for cancer of the colorectum have significantly decreased over the past several decades as a result of increased screening and drastic improvements in treatment. In Maryland alone, approximately 70% of adults over the age of 50 have an up-to-date colorectal cancer screening, helping contribute to the reduction in mortality rates.

Dr. Ralph V. Boccia, an oncology and hematology specialist at Regional Cancer Care Associates (RCCA) in Bethesda and Germantown, Maryland says, “The more colorectal screening we have and the earlier it gets started, the lower the stage that the cancer is typically picked up.” In turn, early detection has led to the state’s lower mortality rates over time.

 

The Benefits Of Increased Screening

According to Dr. Boccia, improving screening rates “affects the stage at which the cancer presents itself and [the patient’s] potential for survival.” Between 2002 and 2010, the percentage of Maryland adults with up-to-date colorectal cancer screenings increased from 64% to 71%. As a result, CRC mortality rates in Maryland decreased considerably among both men and women in that eight-year timeframe. Dr. Boccia explains, “The trend we’ve actually seen – which is that more people are being screened – has resulted in more improvements of overall survival in patients with colorectal cancer.”

However, as colon cancer rates decline in adults 50 years and older, both incidence and death rates are increasing in the under-50 population. “We’re seeing a scary trend of younger patients getting colorectal cancer,” remarks Dr. Boccia, “even down into the 20s.” However, at this point in time, there’s insufficient data to clearly identify the causation behind this trend.

 

Colorectal Cancer Risk Factors

According to a report from the Maryland Department of Health and Mental Hygiene, the incidence rate of colon cancer per 100,000 people in Maryland was 1,174 for men and 1,109 for women in 2012. When looking at new cases of CRC, research shows that incidence may be tied to habits and lifestyles. Among these lifestyle- associated risk factors are being overweight or obese, lack of physical activity, smoking, heavy alcohol use and certain types of diets.

As outlined by the American Cancer Society, other risk factors unrelated to lifestyle choices are personal and family histories of colorectal cancer or adenomatous polyps, having type 2 diabetes, possessing an inherited syndrome, such as Lynch Syndrome, and certain racial and ethnic backgrounds. In addition, Dr. Boccia notes that a personal history of inflammatory bowel disease may increase the risk for developing colorectal cancer. “Patients with ulcerative colitis have to be screened very frequently for colon cancer,” Dr. Boccia elucidates, “because of that high predisposition.”

 

Common CRC Treatments

“For early stage colorectal cancer, the treatment of choice is surgery,” says Dr. Boccia. In this stage, a group of abnormal cells, referred to as carcinoma in situ (CIS), can be removed by a polypectomy, or a part of the colon can be removed via a partial colectomy. Once the cancer has penetrated the wall of the colon and perhaps even grown into nearby tissue, patients of RCCA Maryland will typically undergo active surveillance – although other treatment options are offered to those with high-risk tumors, says Dr. Boccia.

Once the cancer has reached Stage III, patients are generally offered a form of chemotherapy for roughly six weeks. “FOLFOX is the adjuvant therapy of choice,” says Dr. Boccia, “and that we know will lower the incidence of recurrence by about 40-50%.” For Stage IV diseases, which make up about 20% of the cases that RCCA Maryland sees each year, chemotherapy, targeted therapy and even immunotherapy can be used to offer aggressive treatment. If they no longer respond to a particular drug, patients will be introduced to a new regimen.

In regards to new research and treatment options, Dr. Boccia concludes, “I have 50 to 60 clinical trials open at all times in the center, so we’re always looking actively for good, cutting-edge therapies and offering those to our patients.”

 

If you or someone you love has been diagnosed with colorectal cancer, schedule an appointment at one of RCCA’s 29 locations in New Jersey, Maryland or Connecticut for personalized, professional care.

Molecular Testing: Tailoring Treatment by Targeting Pathways

Phillip D. Reid, MD

 

What is molecular testing? How it is used in cancer care?

A.  As we learn how to treat specific subtypes of cancer more accurately, molecular testing, molecular medicine and molecular diagnostics are becoming more prominent in oncology.

In the past, once a cancer was diagnosed, we determined the organ where it started, how much cancer was in the body and where it was. We have since discovered many pathways through which a cancer develops. We now need to know not only the stage, type and origin of cancer, but also the pathway through which it developed and then target that pathway.

 

How does the pathway concept affect therapy selection?

A.  It enhances our ability to treat the cancer, but we now need extra testing on a patient’s particular cancer cells. The great thing about molecular testing is we get an answer specific for the individual, not just for everyone, for example, with lung cancer. But it does require more time for us to find the pathway. From the patient’s standpoint, diagnosis and stage are obtained, and then sometimes we have to send off the cancer cells for extra testing, which increases the time between diagnosis and treatment. But ultimately, a better sense is provided of what drug to use and when to use it, and there’s a much greater likelihood of devising specific, effective treatment.

 

For which types of cancer should molecular testing be used?

A.  Molecular testing has revolutionized every major cancer diagnosis. Patients with lung and breast cancer are the best candidates, but molecular testing also is useful in colon cancer, head-and-neck and bladder cancer, and some leukemias and myelomas.

 

What have been the main developments over the last two to three years with molecular testing?

A.  It’s becoming easier and more standardized to get molecular testing done. A patient receives a diagnosis and his or her cancer is sent off to a lab, which evaluates all known pathways for that cancer. A specific result is received. As the patient receives therapy, sometimes the cancer changes and he or she may need a second or third biopsy one to three years after the initial diagnosis to see what’s changed in the cancer, and then the treatment changes based on that result. We now see cancer as a moving target as it progresses, and we have to recalibrate every few years so that we’re shooting that target correctly.

 

What should patients know about molecular testing before proceeding?

A.  After a patient receives his or her staging diagnosis, the next question is, “What subtype of lung cancer do I have and what pathway did the cancer use to develop?” The patient needs to have patience, as that extra information may not arrive for two to four weeks, but that information can increase the chances of treatment success.

Also ask about clinical trials of cancer medications before beginning therapy, because we often know about upcoming medications that are effective and possibly better than what we have right now.

Colorectal Cancer Trends and Treatment

Ralph V. Boccia, MD, a cancer specialist at RCCA Maryland, provides some insight into recent colorectal cancer trends and treatments that are giving new hope to doctors, researchers and patients nationwide. Overall, Dr. Boccia finds much to be encouraged by, but also points to the need for awareness of a concerning development in the field of colorectal cancer.

 

How Far We’ve Come and Where We’re Going

As a whole, colorectal cancer rates have been dropping. According to the National Cancer Institute and Centers for Disease Control and Prevention, Maryland alone has seen a 2.6% decrease in the amount of new CRC patients diagnosed over a five-year period. Dr. Boccia believes this trend can be partly attributed to the following:

  • Widespread increase in colonoscopies and other CRC screening methods
  • Early detection and removal of polyps before they become cancerous
  • More cases being diagnosed at an early stage – when the cancer is more responsive to treatment

Despite the good news, it’s still projected that 2,358 Maryland residents will be diagnosed and that 927 people will die from the disease this year, says Dr. Boccia. Doctors have also been noticing an uncharacteristic increase in the amount of younger adults being diagnosed with CRC. Since it typically affects individuals above the age of 50, this emerging demographic has been cause for concern. But Dr. Boccia and his colleagues will continue to conduct research and make further strides in colorectal cancer care to better serve patients of all ages.

 

Current Treatment Options

Surgical innovations, targeted therapies, immunotherapies, chemotherapy and clinical trials are paving the way for more effective CRC solutions. Dr. Boccia explains, “We have a greater ability than ever before to individualize care, and to offer patients multi-modal treatment regimens that employ a variety of mechanisms of action to combat cancer by different means.”

 

Reducing Your Risk

Follow these tips to help reduce your risk for developing colorectal cancer:

  • Maintain a healthy weight
  • Stay physically active
  • Avoid smoking cigarettes and only drink alcohol in moderation
  • Get a CRC screening regularly
  • Consult a physician right away if you experience any CRC symptoms, such as blood in the stool and persistent abdominal pain
  • Manage other conditions that may increase your risk for CRC, like type 2 diabetes, inflammatory bowel disease and adenomatous polyps

 

If you or someone you love has been diagnosed with colorectal cancer, schedule an appointment at one of RCCA’s 29 locations in New Jersey, Maryland or Connecticut for personalized, professional care.

RCCA Earns URAC Accreditation In Specialty Pharmacy

[Hackensack, NJ] – RCCA is proud to announce that it has earned URAC accreditation in Specialty Pharmacy. URAC is the independent leader in promoting healthcare quality through accreditation, certification and measurement. By achieving this status, RCCA has demonstrated a comprehensive commitment to quality care, improved processes and better patient outcomes.

 

“URAC Accreditation is a testament to the commitment of delivering the highest level of quality standards to our patients and their caregivers,” said Terrill Jordan, President and CEO of RCCA. ”This type of commitment is the cornerstone of everything we do at RCCA,” he added.

Edward Licitra, MD, PhD, RCCA Chairperson of the Board and RCCA Pharmacy Medical Director and Eileen Peng, PharmD, Director of the RCCA Pharmacy agree that “this new recognition will allow us to continue to provide the highest level of patient care and convenience for the people that need it the most.”

 

“Pharmacy services have never played such an important role in the delivery of care as they do today. RCCA distinguishes itself for having voluntarily undergone a rigorous review of quality standards that earned it URAC accreditation,” said URAC President and CEO Kylanne Green. “Independent URAC accreditation shows RCCA is dedicated to quality and safety, and that it strives for a continual improvement of its services.”

ABOUT RCCA

Regional Cancer Care Associates (RCCA), one of the largest oncology physician networks in the United States, is transforming oncology care by ensuring that cancer patients have access to the highest-quality, most-comprehensive, cutting edge treatments in a compassionate and community-based setting. RCCA includes more than 100 cancer care specialists and is supported by 800 employees at more than 30 care delivery sites, providing care to more than 24,000 new patients annually and over 240,000 existing patients.  For more information visit: http://www.RCCA.com

About URAC

Founded in 1990, URAC is the independent leader in promoting healthcare quality through accreditation, certification and measurement. URAC is a nonprofit organization developing evidence-based measures and standards through inclusive engagement with a range of stakeholders committed to improving the quality of healthcare. Our portfolio of accreditation and certification programs span the healthcare industry, addressing healthcare management, healthcare operations, health plans, pharmacies, telehealth providers, physician practices, and more. URAC accreditation is a symbol of excellence for organizations to showcase their validated commitment to quality and accountability.

For further information, contact:

Mary Lou Salvemini
msalvemini@regionalcancercare.org
(201) 510-0922

RCCA Makes Innovative UnitedHealthcare Cancer Care Program Available to Patients in Maryland

HACKENSACK, N.J., Nov. 22, 2016 /PRNewswire-USNewswire/ — Regional Cancer Care Associates (RCCA) is expanding its cancer care payment initiative with UnitedHealthcare to RCCA patients in Maryland who are covered by UnitedHealthcare benefit plans.

The program, made available at RCCA New Jersey locations in January, rewards physicians for focusing on best treatment practices, quality patient care and better health outcomes. The program pays participating medical oncologists more if they demonstrate superior clinical results and if they reduce the total cost of care.

The episode payment model shifts reimbursement away from the current “fee-for-service” approach that emphasizes volume of care delivered regardless of a patient’s health outcomes. The episode payment is based on the expected cost of a standard treatment regimen for a specific condition, as predetermined by the doctor. Similar payment models have been shown to enhance care coordination and improve health outcomes for patients, while reducing overall costs.

“RCCA has emerged as a leader in delivering the highest-level quality cancer care to our patients,” said Terrill Jordan, RCCA President and CEO. “New payment methodologies like this put patients’ interests at the forefront of cancer treatment. It also results in significant cost savings, which advances efforts across the country to assist in controlling rising health care costs. We are excited to offer this program to our Maryland patient base.”

Lee N. Newcomer, M.D., UnitedHealthcare’s Senior Vice President, Oncology, said: “Our partnership with RCCA marks an important step toward expanded episode payment models and away from the traditional fee-for-service payments for oncology care. We look forward to working with RCCA and others to expand our efforts to identify best practices for treating cancer.”

A study published in the Journal of Oncology Practice has demonstrated that this program reduced overall cancer expenses by more than a third while improving quality outcomes. RCCA is among five oncology practices that have joined the program, which now has a total of more than 650 oncologists. RCCA in New Jersey and now Maryland comprise approximately 100 of these oncologists.

“Value-based cancer care is here. This program will enable Maryland-based RCCA oncologists to continue to provide patient-centered care at the highest level of quality,” said Ralph Boccia, M.D., RCCA Research Deputy Chair and Oncologist in Bethesda and Germantown, Md.

UnitedHealthcare first implemented its episode payment program as a pilot study between October 2009 and December 2012. The pilot study produced a significant reduction in hospitalizations and a 34 percent reduction in total costs while improving quality. Click here to read results of the study.

About RCCA
Regional Cancer Care Associates (RCCA), one of the largest oncology physician networks in the United States, is transforming oncology care by ensuring that cancer patients have access to the highest-quality, most-comprehensive, cutting edge treatments in a compassionate and community-based setting. RCCA includes 100 cancer care specialists and is supported by 700 employees at 27 care delivery sites, providing care to more than 230,000 existing patients in New Jersey, Maryland and Washington DC.  For more information visit: http://www.RCCA.com

Contact:

Mary Lou Salvemini
msalvemini@regionalcancercare.org
(201) 510-0922

REGIONAL CANCER CARE ASSOCIATES AND AETNA FORM ONCOLOGY MEDICAL HOME

REGIONAL CANCER CARE ASSOCIATES AND AETNA FORM ONCOLOGY MEDICAL HOME

— The Patient-Focused Model Supports High-Value Care–

 

Hackensack, NJ, October 12, 2016 — Regional Cancer Care Associates (RCCA) and Aetna (NYSE: AET) announced a collaboration to create an oncology medical home that is designed to improve the care experience for cancer patients.

In the oncology medical home model, teams of cancer specialists collectively provide a patient’s health care when he or she has a cancer diagnosis. The model will give RCCA the responsibility to arrange appropriate care that is continuous and proactive and physicians will be incentivized for improved health, affordability and a better patient experience.

The oncology medical home arrangement will be available to patients at all RCCA locations in New Jersey and Maryland.

“RCCA is excited to partner with Aetna on this program. It aligns with our vision of providing patient centered care close to home,” said Terrill Jordan, RCCA President & CEO. “This partnership will not only enable us to continue the delivery of high quality care through reduced side effects, but will also facilitate cost effective care based on the data Aetna will be sharing,” said Michael Ruiz de Somocurcio, RCCA Vice President of Payer and Provider Collaboration.

The model is part of a strategic direction to transition from fee-for-service medicine to value-based payment. Value-based arrangements are emerging as a solution to address rising health care costs, clinical inefficiency, duplication of services, and access to care. In value-based models, doctors and hospitals are paid for helping to keep people healthy and for improving the health of those who have chronic conditions in an evidence-based, cost-effective way.

“We understand that cancer treatment can be the hardest experience that our members will ever have to go through,” said Daniel Knecht, M.D., M.B.A., Aetna’s Head of Strategy & Planning and Interim Head of Oncology Solutions. “This oncology medical home with RCCA will help provide our members with high-quality care and an optimal patient experience.”

The operating principles of the RCCA and Aetna oncology medical home include:

  • An orientation to the whole person. A personal physician from RCCA will be responsible for providing or arranging all of a patient’s health care needs with other qualified professionals. This includes care for all stages of treatment: preventive services, acute care, chronic care, palliative care and end-of-life care.
  • Evidence-based, personalized medical care. The RCCA team will focus on making treatment decisions based on current medical evidence for each unique disease presentation, patient-specific factors and patient choice using appropriate treatments to improve quality and outcomes.
  • Coordinated and integrated care. Care will be facilitated, across all elements of the health system, to enable Aetna members to get the appropriate care when and where it is needed and wanted, in a culturally and linguistically appropriate manner.
  • Quality and safety. Quality and safety will be a focus of care, including the use of evidence-based medicine, clinical decision support tools and accountability for continuous quality improvement.
  • Enhanced access to care. Care will be available through systems such as open scheduling, expanded hours and new options for communication between Aetna members, their personal physicians and hospital staff.

The oncology medical home arrangement launched in September 2016.

About RCCA

Regional Cancer Care Associates (RCCA), one of the largest oncology physician networks in the United States, is transforming oncology care by ensuring that cancer patients have access to the highest-quality, most-comprehensive, cutting edge treatments in a compassionate and community-based setting. RCCA includes 100 cancer care specialists and is supported by 700 employees at 27 care delivery sites, providing care to more than 23,000 new patients annually and over 230,000 existing patients in New Jersey, Maryland and Washington DC. For more information visit: http://www.RCCA.com.

About Aetna

Aetna is one of the nation’s leading diversified health care benefits companies, serving an estimated 46.3 million people with information and resources to help them make better informed decisions about their health care. Aetna offers a broad range of traditional, voluntary and consumer-directed health insurance products and related services, including medical, pharmacy, dental, behavioral health, group life and disability plans, and medical management capabilities, Medicaid health care management services, workers’ compensation administrative services and health information technology products and services. Aetna’s customers include employer groups, individuals, college students, part-time and hourly workers, health plans, health care providers, governmental units, government-sponsored plans, labor groups and expatriates. For more information, see www.aetna.com and learn about how Aetna is helping to build a healthier world. @AetnaNews

 

###

What Cancer Patients Need To Know About Clinical Trials: Insights From New Jersey Hematologist /Oncologist Seth Berk

Seth Howard Berk, MD, a hematologist and medical oncologist with RCCA, reveals four facts that he shares with his patients when they ask about clinical trials.

First, a drug has been thoroughly tested well before it reaches the clinical trial stage. Pre-clinical trial testing involves looking at a drug’s effects on animals as well as human cells. This stage usually takes years of development. Also, the clinical studies have to be designed and conducted in accordance with rigorous ethical and safety criteria.

He also imparts the importance of not thinking of clinical trials as a last resort in treatment. While trials are typically suited for situations in which traditional therapy methods are not working for a patient, there is more evidence emerging of late-stage trials benefitting the patient when used early in the diagnosis process.

A myth that Dr. Berk debunks is the use of a placebo in cancer treatment. Some cancer patients are resistant to clinical trials because they fear there will be a placebo and they will suffer as a result. He says this is misinformation or something assumed from a patient’s memory of high school or college science experiments. In clinical trials, one group will be administered the trial agent while the other continues to have traditional therapy. There are rarely ever patients receiving zero care.

Lastly, Dr. Berk addresses the importance of clinical trials for cancer patients in general. Because of willing patients participating in more and more trials, doctors and patients can share in a community of knowledge and understanding, and, one day, a cure.

To read more about clinical trials, turn to “What cancer patients need to know about clinical trials: Insights from New Jersey oncologist/hematologist Seth Berk.”

RCCA: Taking Cancer Care To A Higher Level In NJ And Beyond

Edward J. Licitra, MD, PhD, board certified in internal medicine, hematology and medical oncology and chairman of the board of directors of Regional Cancer Care Associates (RCCA), shares some of his thoughts on potential models for a health care delivery reform system. Oncologists at RCCA, totaling 100 physicians, learn from each other’s best practices with the patient’s interest at the forefront. Through RCCA, patients can receive care at home instead of visiting a hospital or clinic. They have set up 27 care delivery sites, providing care to more than 23,000 new patients annually and approximately 230,000 existing patients in New Jersey, Maryland and Washington, D.C.

Another example of a successful care reform case is the Oncology Care Model (OCM) created by Medicare under the Affordable Care Act (ACA). The model questions how to best develop an integrated style of cancer care. It focuses on developing a care model for the future, using data sharing and streamlining economics for patients as well as providers. By digitizing patients’ medical histories and sharing them through hospitals and clinics, this model focuses on simplifying the oncology care process.

Lastly, the OCM utilizes evidence-based-medicine (EBM) practices throughout the entire spectrum of care. EBM produces the best methods regardless of cost, while even reducing cost by eliminating wasteful spending. The OCM focuses on patient-focused, research based therapy tailored to the individual patient.

To learn more about this topic, read “RCCA: Taking cancer care to a higher level in NJ and beyond.”

Targeting Treatments for Chronic Lymphocytic Leukemia

Dr. Joel Silver

 

How do myeloma and chronic lymphocytic leukemia (CLL) develop? What are some risk factors associated with those malignancies?

A. We don’t know what causes CLL. We do know that people in some occupations or with a certain exposure history might be at higher risk, and that CLL generally affects older people. Treatment fortunately is not needed in many cases, but even so our treatment options have evolved based on cytogenetics and next-generation sequencing. We have more ways to assess prognostic features and design more personalized and potentially more effective therapy for people with CLL.

 

What therapies have been successful in treating CLL over the last two to three years?

A. If you can identify a certain kind of CLL, such as IDH-mutated CLL, some of the patients with it can receive a standard chemotherapy regimen called FCR, and they sometimes go into remission indefinitely. It depends on whether the patient is young and healthy enough to tolerate the therapy. That’s a select group, though; you don’t see too many young people with CLL.

Years ago, an effective treatment did not exist for another group of patients with CLL, those with the genetic 17p deletion. In recent years, however, the oral agent ibrutinib has shown effectiveness for CLL in this group. Other therapies now are available for patients who don’t respond to ibrutinib.

 

Where does targeted therapy come into play?

A. In general, “targeted therapy” refers to a treatment based on a particular mutation or pattern. The presence of the genetic 17p deletion in CLL is one example, but this is a bad cytogenetic abnormality for which standard treatments such as chemotherapy haven’t worked. If we can identify a particular mutation, then we can target our therapy and plan treatment that we know will work, instead of going through chemotherapies that are only partially effective or downright ineffective and then finding that the patient is resistant to treatment.

 

Are there side effects or drawbacks to targeted therapy?

A. Everything we do has side effects. The oral agent ibrutinib has been an effective first-line therapy for any type of CLL. Although the agent is specifically for patients with 17p deletion, it has also worked for patients without that genetic feature. While some cardiovascular and bleeding issues have been reported, ibrutinib overall is more tolerable than chemotherapy.

When we medically examine patients with CLL, we always look at a pattern of mutations to try to identify how to treat these people — not so much from an immediate therapeutic standpoint, but to gain knowledge of all these other cytogenetic abnormalities so that eventually, we will find other ways to target those different patterns.

What important points do you address with patients before they begin CLL therapy?

A. Many people with CLL don’t die of their disease, they die with their disease, so I tell patients not to be afraid of the disease itself. Many of the conversations we have with these people, however, revolve around the fact that they have this problem but may never need treatment. “We should follow you because you may need treatment down the line,” I tell them. “If you need treatment, we have many effective therapies.”

 

Do you foresee different therapies for CLL emerging within the next two to three years?

A. A number of medications are on the horizon that will be appropriate for any patient with CLL. For example, venetoclax, which gained FDA approval last year, is indicated for second-line treatment of CLL in patients with the 17p deletion, but I think that agent will be effective for all patients with CLL. As similarly versatile agents are developed, we will have many more treatment options.

Colorectal Cancer Trends in Maryland: A Conversation with Dr. Ralph V. Boccia

As the third most common cancer in the United States, colorectal cancer (CRC) affects about 1 in 20 Americans. However, incidence and death rates for cancer of the colorectum have significantly decreased over the past several decades as a result of increased screening and drastic improvements in treatment. In Maryland alone, approximately 70% of adults over the age of 50 have an up-to-date colorectal cancer screening, helping contribute to the reduction in mortality rates.

Dr. Ralph V. Boccia, an oncology and hematology specialist at Regional Cancer Care Associates (RCCA) in Bethesda and Germantown, Maryland says, “The more colorectal screening we have and the earlier it gets started, the lower the stage that the cancer is typically picked up.” In turn, early detection has led to the state’s lower mortality rates over time.

 

The Benefits Of Increased Screening

According to Dr. Boccia, improving screening rates “affects the stage at which the cancer presents itself and [the patient’s] potential for survival.” Between 2002 and 2010, the percentage of Maryland adults with up-to-date colorectal cancer screenings increased from 64% to 71%. As a result, CRC mortality rates in Maryland decreased considerably among both men and women in that eight-year timeframe. Dr. Boccia explains, “The trend we’ve actually seen – which is that more people are being screened – has resulted in more improvements of overall survival in patients with colorectal cancer.”

However, as colon cancer rates decline in adults 50 years and older, both incidence and death rates are increasing in the under-50 population. “We’re seeing a scary trend of younger patients getting colorectal cancer,” remarks Dr. Boccia, “even down into the 20s.” However, at this point in time, there’s insufficient data to clearly identify the causation behind this trend.

 

Colorectal Cancer Risk Factors

According to a report from the Maryland Department of Health and Mental Hygiene, the incidence rate of colon cancer per 100,000 people in Maryland was 1,174 for men and 1,109 for women in 2012. When looking at new cases of CRC, research shows that incidence may be tied to habits and lifestyles. Among these lifestyle- associated risk factors are being overweight or obese, lack of physical activity, smoking, heavy alcohol use and certain types of diets.

As outlined by the American Cancer Society, other risk factors unrelated to lifestyle choices are personal and family histories of colorectal cancer or adenomatous polyps, having type 2 diabetes, possessing an inherited syndrome, such as Lynch Syndrome, and certain racial and ethnic backgrounds. In addition, Dr. Boccia notes that a personal history of inflammatory bowel disease may increase the risk for developing colorectal cancer. “Patients with ulcerative colitis have to be screened very frequently for colon cancer,” Dr. Boccia elucidates, “because of that high predisposition.”

 

Common CRC Treatments

“For early stage colorectal cancer, the treatment of choice is surgery,” says Dr. Boccia. In this stage, a group of abnormal cells, referred to as carcinoma in situ (CIS), can be removed by a polypectomy, or a part of the colon can be removed via a partial colectomy. Once the cancer has penetrated the wall of the colon and perhaps even grown into nearby tissue, patients of RCCA Maryland will typically undergo active surveillance – although other treatment options are offered to those with high-risk tumors, says Dr. Boccia.

Once the cancer has reached Stage III, patients are generally offered a form of chemotherapy for roughly six weeks. “FOLFOX is the adjuvant therapy of choice,” says Dr. Boccia, “and that we know will lower the incidence of recurrence by about 40-50%.” For Stage IV diseases, which make up about 20% of the cases that RCCA Maryland sees each year, chemotherapy, targeted therapy and even immunotherapy can be used to offer aggressive treatment. If they no longer respond to a particular drug, patients will be introduced to a new regimen.

In regards to new research and treatment options, Dr. Boccia concludes, “I have 50 to 60 clinical trials open at all times in the center, so we’re always looking actively for good, cutting-edge therapies and offering those to our patients.”

 

If you or someone you love has been diagnosed with colorectal cancer, schedule an appointment at one of RCCA’s 29 locations in New Jersey, Maryland or Connecticut for personalized, professional care.

Molecular Testing: Tailoring Treatment by Targeting Pathways

Phillip D. Reid, MD

 

What is molecular testing? How it is used in cancer care?

A.  As we learn how to treat specific subtypes of cancer more accurately, molecular testing, molecular medicine and molecular diagnostics are becoming more prominent in oncology.

In the past, once a cancer was diagnosed, we determined the organ where it started, how much cancer was in the body and where it was. We have since discovered many pathways through which a cancer develops. We now need to know not only the stage, type and origin of cancer, but also the pathway through which it developed and then target that pathway.

 

How does the pathway concept affect therapy selection?

A.  It enhances our ability to treat the cancer, but we now need extra testing on a patient’s particular cancer cells. The great thing about molecular testing is we get an answer specific for the individual, not just for everyone, for example, with lung cancer. But it does require more time for us to find the pathway. From the patient’s standpoint, diagnosis and stage are obtained, and then sometimes we have to send off the cancer cells for extra testing, which increases the time between diagnosis and treatment. But ultimately, a better sense is provided of what drug to use and when to use it, and there’s a much greater likelihood of devising specific, effective treatment.

 

For which types of cancer should molecular testing be used?

A.  Molecular testing has revolutionized every major cancer diagnosis. Patients with lung and breast cancer are the best candidates, but molecular testing also is useful in colon cancer, head-and-neck and bladder cancer, and some leukemias and myelomas.

 

What have been the main developments over the last two to three years with molecular testing?

A.  It’s becoming easier and more standardized to get molecular testing done. A patient receives a diagnosis and his or her cancer is sent off to a lab, which evaluates all known pathways for that cancer. A specific result is received. As the patient receives therapy, sometimes the cancer changes and he or she may need a second or third biopsy one to three years after the initial diagnosis to see what’s changed in the cancer, and then the treatment changes based on that result. We now see cancer as a moving target as it progresses, and we have to recalibrate every few years so that we’re shooting that target correctly.

 

What should patients know about molecular testing before proceeding?

A.  After a patient receives his or her staging diagnosis, the next question is, “What subtype of lung cancer do I have and what pathway did the cancer use to develop?” The patient needs to have patience, as that extra information may not arrive for two to four weeks, but that information can increase the chances of treatment success.

Also ask about clinical trials of cancer medications before beginning therapy, because we often know about upcoming medications that are effective and possibly better than what we have right now.

Colorectal Cancer Trends and Treatment

Ralph V. Boccia, MD, a cancer specialist at RCCA Maryland, provides some insight into recent colorectal cancer trends and treatments that are giving new hope to doctors, researchers and patients nationwide. Overall, Dr. Boccia finds much to be encouraged by, but also points to the need for awareness of a concerning development in the field of colorectal cancer.

 

How Far We’ve Come and Where We’re Going

As a whole, colorectal cancer rates have been dropping. According to the National Cancer Institute and Centers for Disease Control and Prevention, Maryland alone has seen a 2.6% decrease in the amount of new CRC patients diagnosed over a five-year period. Dr. Boccia believes this trend can be partly attributed to the following:

  • Widespread increase in colonoscopies and other CRC screening methods
  • Early detection and removal of polyps before they become cancerous
  • More cases being diagnosed at an early stage – when the cancer is more responsive to treatment

Despite the good news, it’s still projected that 2,358 Maryland residents will be diagnosed and that 927 people will die from the disease this year, says Dr. Boccia. Doctors have also been noticing an uncharacteristic increase in the amount of younger adults being diagnosed with CRC. Since it typically affects individuals above the age of 50, this emerging demographic has been cause for concern. But Dr. Boccia and his colleagues will continue to conduct research and make further strides in colorectal cancer care to better serve patients of all ages.

 

Current Treatment Options

Surgical innovations, targeted therapies, immunotherapies, chemotherapy and clinical trials are paving the way for more effective CRC solutions. Dr. Boccia explains, “We have a greater ability than ever before to individualize care, and to offer patients multi-modal treatment regimens that employ a variety of mechanisms of action to combat cancer by different means.”

 

Reducing Your Risk

Follow these tips to help reduce your risk for developing colorectal cancer:

  • Maintain a healthy weight
  • Stay physically active
  • Avoid smoking cigarettes and only drink alcohol in moderation
  • Get a CRC screening regularly
  • Consult a physician right away if you experience any CRC symptoms, such as blood in the stool and persistent abdominal pain
  • Manage other conditions that may increase your risk for CRC, like type 2 diabetes, inflammatory bowel disease and adenomatous polyps

 

If you or someone you love has been diagnosed with colorectal cancer, schedule an appointment at one of RCCA’s 29 locations in New Jersey, Maryland or Connecticut for personalized, professional care.

RCCA Earns URAC Accreditation In Specialty Pharmacy

[Hackensack, NJ] – RCCA is proud to announce that it has earned URAC accreditation in Specialty Pharmacy. URAC is the independent leader in promoting healthcare quality through accreditation, certification and measurement. By achieving this status, RCCA has demonstrated a comprehensive commitment to quality care, improved processes and better patient outcomes.

 

“URAC Accreditation is a testament to the commitment of delivering the highest level of quality standards to our patients and their caregivers,” said Terrill Jordan, President and CEO of RCCA. ”This type of commitment is the cornerstone of everything we do at RCCA,” he added.

Edward Licitra, MD, PhD, RCCA Chairperson of the Board and RCCA Pharmacy Medical Director and Eileen Peng, PharmD, Director of the RCCA Pharmacy agree that “this new recognition will allow us to continue to provide the highest level of patient care and convenience for the people that need it the most.”

 

“Pharmacy services have never played such an important role in the delivery of care as they do today. RCCA distinguishes itself for having voluntarily undergone a rigorous review of quality standards that earned it URAC accreditation,” said URAC President and CEO Kylanne Green. “Independent URAC accreditation shows RCCA is dedicated to quality and safety, and that it strives for a continual improvement of its services.”

ABOUT RCCA

Regional Cancer Care Associates (RCCA), one of the largest oncology physician networks in the United States, is transforming oncology care by ensuring that cancer patients have access to the highest-quality, most-comprehensive, cutting edge treatments in a compassionate and community-based setting. RCCA includes more than 100 cancer care specialists and is supported by 800 employees at more than 30 care delivery sites, providing care to more than 24,000 new patients annually and over 240,000 existing patients.  For more information visit: http://www.RCCA.com

About URAC

Founded in 1990, URAC is the independent leader in promoting healthcare quality through accreditation, certification and measurement. URAC is a nonprofit organization developing evidence-based measures and standards through inclusive engagement with a range of stakeholders committed to improving the quality of healthcare. Our portfolio of accreditation and certification programs span the healthcare industry, addressing healthcare management, healthcare operations, health plans, pharmacies, telehealth providers, physician practices, and more. URAC accreditation is a symbol of excellence for organizations to showcase their validated commitment to quality and accountability.

For further information, contact:

Mary Lou Salvemini
msalvemini@regionalcancercare.org
(201) 510-0922

RCCA Makes Innovative UnitedHealthcare Cancer Care Program Available to Patients in Maryland

HACKENSACK, N.J., Nov. 22, 2016 /PRNewswire-USNewswire/ — Regional Cancer Care Associates (RCCA) is expanding its cancer care payment initiative with UnitedHealthcare to RCCA patients in Maryland who are covered by UnitedHealthcare benefit plans.

The program, made available at RCCA New Jersey locations in January, rewards physicians for focusing on best treatment practices, quality patient care and better health outcomes. The program pays participating medical oncologists more if they demonstrate superior clinical results and if they reduce the total cost of care.

The episode payment model shifts reimbursement away from the current “fee-for-service” approach that emphasizes volume of care delivered regardless of a patient’s health outcomes. The episode payment is based on the expected cost of a standard treatment regimen for a specific condition, as predetermined by the doctor. Similar payment models have been shown to enhance care coordination and improve health outcomes for patients, while reducing overall costs.

“RCCA has emerged as a leader in delivering the highest-level quality cancer care to our patients,” said Terrill Jordan, RCCA President and CEO. “New payment methodologies like this put patients’ interests at the forefront of cancer treatment. It also results in significant cost savings, which advances efforts across the country to assist in controlling rising health care costs. We are excited to offer this program to our Maryland patient base.”

Lee N. Newcomer, M.D., UnitedHealthcare’s Senior Vice President, Oncology, said: “Our partnership with RCCA marks an important step toward expanded episode payment models and away from the traditional fee-for-service payments for oncology care. We look forward to working with RCCA and others to expand our efforts to identify best practices for treating cancer.”

A study published in the Journal of Oncology Practice has demonstrated that this program reduced overall cancer expenses by more than a third while improving quality outcomes. RCCA is among five oncology practices that have joined the program, which now has a total of more than 650 oncologists. RCCA in New Jersey and now Maryland comprise approximately 100 of these oncologists.

“Value-based cancer care is here. This program will enable Maryland-based RCCA oncologists to continue to provide patient-centered care at the highest level of quality,” said Ralph Boccia, M.D., RCCA Research Deputy Chair and Oncologist in Bethesda and Germantown, Md.

UnitedHealthcare first implemented its episode payment program as a pilot study between October 2009 and December 2012. The pilot study produced a significant reduction in hospitalizations and a 34 percent reduction in total costs while improving quality. Click here to read results of the study.

About RCCA
Regional Cancer Care Associates (RCCA), one of the largest oncology physician networks in the United States, is transforming oncology care by ensuring that cancer patients have access to the highest-quality, most-comprehensive, cutting edge treatments in a compassionate and community-based setting. RCCA includes 100 cancer care specialists and is supported by 700 employees at 27 care delivery sites, providing care to more than 230,000 existing patients in New Jersey, Maryland and Washington DC.  For more information visit: http://www.RCCA.com

Contact:

Mary Lou Salvemini
msalvemini@regionalcancercare.org
(201) 510-0922

REGIONAL CANCER CARE ASSOCIATES AND AETNA FORM ONCOLOGY MEDICAL HOME

REGIONAL CANCER CARE ASSOCIATES AND AETNA FORM ONCOLOGY MEDICAL HOME

— The Patient-Focused Model Supports High-Value Care–

 

Hackensack, NJ, October 12, 2016 — Regional Cancer Care Associates (RCCA) and Aetna (NYSE: AET) announced a collaboration to create an oncology medical home that is designed to improve the care experience for cancer patients.

In the oncology medical home model, teams of cancer specialists collectively provide a patient’s health care when he or she has a cancer diagnosis. The model will give RCCA the responsibility to arrange appropriate care that is continuous and proactive and physicians will be incentivized for improved health, affordability and a better patient experience.

The oncology medical home arrangement will be available to patients at all RCCA locations in New Jersey and Maryland.

“RCCA is excited to partner with Aetna on this program. It aligns with our vision of providing patient centered care close to home,” said Terrill Jordan, RCCA President & CEO. “This partnership will not only enable us to continue the delivery of high quality care through reduced side effects, but will also facilitate cost effective care based on the data Aetna will be sharing,” said Michael Ruiz de Somocurcio, RCCA Vice President of Payer and Provider Collaboration.

The model is part of a strategic direction to transition from fee-for-service medicine to value-based payment. Value-based arrangements are emerging as a solution to address rising health care costs, clinical inefficiency, duplication of services, and access to care. In value-based models, doctors and hospitals are paid for helping to keep people healthy and for improving the health of those who have chronic conditions in an evidence-based, cost-effective way.

“We understand that cancer treatment can be the hardest experience that our members will ever have to go through,” said Daniel Knecht, M.D., M.B.A., Aetna’s Head of Strategy & Planning and Interim Head of Oncology Solutions. “This oncology medical home with RCCA will help provide our members with high-quality care and an optimal patient experience.”

The operating principles of the RCCA and Aetna oncology medical home include:

  • An orientation to the whole person. A personal physician from RCCA will be responsible for providing or arranging all of a patient’s health care needs with other qualified professionals. This includes care for all stages of treatment: preventive services, acute care, chronic care, palliative care and end-of-life care.
  • Evidence-based, personalized medical care. The RCCA team will focus on making treatment decisions based on current medical evidence for each unique disease presentation, patient-specific factors and patient choice using appropriate treatments to improve quality and outcomes.
  • Coordinated and integrated care. Care will be facilitated, across all elements of the health system, to enable Aetna members to get the appropriate care when and where it is needed and wanted, in a culturally and linguistically appropriate manner.
  • Quality and safety. Quality and safety will be a focus of care, including the use of evidence-based medicine, clinical decision support tools and accountability for continuous quality improvement.
  • Enhanced access to care. Care will be available through systems such as open scheduling, expanded hours and new options for communication between Aetna members, their personal physicians and hospital staff.

The oncology medical home arrangement launched in September 2016.

About RCCA

Regional Cancer Care Associates (RCCA), one of the largest oncology physician networks in the United States, is transforming oncology care by ensuring that cancer patients have access to the highest-quality, most-comprehensive, cutting edge treatments in a compassionate and community-based setting. RCCA includes 100 cancer care specialists and is supported by 700 employees at 27 care delivery sites, providing care to more than 23,000 new patients annually and over 230,000 existing patients in New Jersey, Maryland and Washington DC. For more information visit: http://www.RCCA.com.

About Aetna

Aetna is one of the nation’s leading diversified health care benefits companies, serving an estimated 46.3 million people with information and resources to help them make better informed decisions about their health care. Aetna offers a broad range of traditional, voluntary and consumer-directed health insurance products and related services, including medical, pharmacy, dental, behavioral health, group life and disability plans, and medical management capabilities, Medicaid health care management services, workers’ compensation administrative services and health information technology products and services. Aetna’s customers include employer groups, individuals, college students, part-time and hourly workers, health plans, health care providers, governmental units, government-sponsored plans, labor groups and expatriates. For more information, see www.aetna.com and learn about how Aetna is helping to build a healthier world. @AetnaNews

 

###

What Cancer Patients Need To Know About Clinical Trials: Insights From New Jersey Hematologist /Oncologist Seth Berk

Seth Howard Berk, MD, a hematologist and medical oncologist with RCCA, reveals four facts that he shares with his patients when they ask about clinical trials.

First, a drug has been thoroughly tested well before it reaches the clinical trial stage. Pre-clinical trial testing involves looking at a drug’s effects on animals as well as human cells. This stage usually takes years of development. Also, the clinical studies have to be designed and conducted in accordance with rigorous ethical and safety criteria.

He also imparts the importance of not thinking of clinical trials as a last resort in treatment. While trials are typically suited for situations in which traditional therapy methods are not working for a patient, there is more evidence emerging of late-stage trials benefitting the patient when used early in the diagnosis process.

A myth that Dr. Berk debunks is the use of a placebo in cancer treatment. Some cancer patients are resistant to clinical trials because they fear there will be a placebo and they will suffer as a result. He says this is misinformation or something assumed from a patient’s memory of high school or college science experiments. In clinical trials, one group will be administered the trial agent while the other continues to have traditional therapy. There are rarely ever patients receiving zero care.

Lastly, Dr. Berk addresses the importance of clinical trials for cancer patients in general. Because of willing patients participating in more and more trials, doctors and patients can share in a community of knowledge and understanding, and, one day, a cure.

To read more about clinical trials, turn to “What cancer patients need to know about clinical trials: Insights from New Jersey oncologist/hematologist Seth Berk.”

RCCA: Taking Cancer Care To A Higher Level In NJ And Beyond

Edward J. Licitra, MD, PhD, board certified in internal medicine, hematology and medical oncology and chairman of the board of directors of Regional Cancer Care Associates (RCCA), shares some of his thoughts on potential models for a health care delivery reform system. Oncologists at RCCA, totaling 100 physicians, learn from each other’s best practices with the patient’s interest at the forefront. Through RCCA, patients can receive care at home instead of visiting a hospital or clinic. They have set up 27 care delivery sites, providing care to more than 23,000 new patients annually and approximately 230,000 existing patients in New Jersey, Maryland and Washington, D.C.

Another example of a successful care reform case is the Oncology Care Model (OCM) created by Medicare under the Affordable Care Act (ACA). The model questions how to best develop an integrated style of cancer care. It focuses on developing a care model for the future, using data sharing and streamlining economics for patients as well as providers. By digitizing patients’ medical histories and sharing them through hospitals and clinics, this model focuses on simplifying the oncology care process.

Lastly, the OCM utilizes evidence-based-medicine (EBM) practices throughout the entire spectrum of care. EBM produces the best methods regardless of cost, while even reducing cost by eliminating wasteful spending. The OCM focuses on patient-focused, research based therapy tailored to the individual patient.

To learn more about this topic, read “RCCA: Taking cancer care to a higher level in NJ and beyond.”

Targeting Treatments for Chronic Lymphocytic Leukemia

Dr. Joel Silver

 

How do myeloma and chronic lymphocytic leukemia (CLL) develop? What are some risk factors associated with those malignancies?

A. We don’t know what causes CLL. We do know that people in some occupations or with a certain exposure history might be at higher risk, and that CLL generally affects older people. Treatment fortunately is not needed in many cases, but even so our treatment options have evolved based on cytogenetics and next-generation sequencing. We have more ways to assess prognostic features and design more personalized and potentially more effective therapy for people with CLL.

 

What therapies have been successful in treating CLL over the last two to three years?

A. If you can identify a certain kind of CLL, such as IDH-mutated CLL, some of the patients with it can receive a standard chemotherapy regimen called FCR, and they sometimes go into remission indefinitely. It depends on whether the patient is young and healthy enough to tolerate the therapy. That’s a select group, though; you don’t see too many young people with CLL.

Years ago, an effective treatment did not exist for another group of patients with CLL, those with the genetic 17p deletion. In recent years, however, the oral agent ibrutinib has shown effectiveness for CLL in this group. Other therapies now are available for patients who don’t respond to ibrutinib.

 

Where does targeted therapy come into play?

A. In general, “targeted therapy” refers to a treatment based on a particular mutation or pattern. The presence of the genetic 17p deletion in CLL is one example, but this is a bad cytogenetic abnormality for which standard treatments such as chemotherapy haven’t worked. If we can identify a particular mutation, then we can target our therapy and plan treatment that we know will work, instead of going through chemotherapies that are only partially effective or downright ineffective and then finding that the patient is resistant to treatment.

 

Are there side effects or drawbacks to targeted therapy?

A. Everything we do has side effects. The oral agent ibrutinib has been an effective first-line therapy for any type of CLL. Although the agent is specifically for patients with 17p deletion, it has also worked for patients without that genetic feature. While some cardiovascular and bleeding issues have been reported, ibrutinib overall is more tolerable than chemotherapy.

When we medically examine patients with CLL, we always look at a pattern of mutations to try to identify how to treat these people — not so much from an immediate therapeutic standpoint, but to gain knowledge of all these other cytogenetic abnormalities so that eventually, we will find other ways to target those different patterns.

What important points do you address with patients before they begin CLL therapy?

A. Many people with CLL don’t die of their disease, they die with their disease, so I tell patients not to be afraid of the disease itself. Many of the conversations we have with these people, however, revolve around the fact that they have this problem but may never need treatment. “We should follow you because you may need treatment down the line,” I tell them. “If you need treatment, we have many effective therapies.”

 

Do you foresee different therapies for CLL emerging within the next two to three years?

A. A number of medications are on the horizon that will be appropriate for any patient with CLL. For example, venetoclax, which gained FDA approval last year, is indicated for second-line treatment of CLL in patients with the 17p deletion, but I think that agent will be effective for all patients with CLL. As similarly versatile agents are developed, we will have many more treatment options.

Colorectal Cancer Trends in Maryland: A Conversation with Dr. Ralph V. Boccia

As the third most common cancer in the United States, colorectal cancer (CRC) affects about 1 in 20 Americans. However, incidence and death rates for cancer of the colorectum have significantly decreased over the past several decades as a result of increased screening and drastic improvements in treatment. In Maryland alone, approximately 70% of adults over the age of 50 have an up-to-date colorectal cancer screening, helping contribute to the reduction in mortality rates.

Dr. Ralph V. Boccia, an oncology and hematology specialist at Regional Cancer Care Associates (RCCA) in Bethesda and Germantown, Maryland says, “The more colorectal screening we have and the earlier it gets started, the lower the stage that the cancer is typically picked up.” In turn, early detection has led to the state’s lower mortality rates over time.

 

The Benefits Of Increased Screening

According to Dr. Boccia, improving screening rates “affects the stage at which the cancer presents itself and [the patient’s] potential for survival.” Between 2002 and 2010, the percentage of Maryland adults with up-to-date colorectal cancer screenings increased from 64% to 71%. As a result, CRC mortality rates in Maryland decreased considerably among both men and women in that eight-year timeframe. Dr. Boccia explains, “The trend we’ve actually seen – which is that more people are being screened – has resulted in more improvements of overall survival in patients with colorectal cancer.”

However, as colon cancer rates decline in adults 50 years and older, both incidence and death rates are increasing in the under-50 population. “We’re seeing a scary trend of younger patients getting colorectal cancer,” remarks Dr. Boccia, “even down into the 20s.” However, at this point in time, there’s insufficient data to clearly identify the causation behind this trend.

 

Colorectal Cancer Risk Factors

According to a report from the Maryland Department of Health and Mental Hygiene, the incidence rate of colon cancer per 100,000 people in Maryland was 1,174 for men and 1,109 for women in 2012. When looking at new cases of CRC, research shows that incidence may be tied to habits and lifestyles. Among these lifestyle- associated risk factors are being overweight or obese, lack of physical activity, smoking, heavy alcohol use and certain types of diets.

As outlined by the American Cancer Society, other risk factors unrelated to lifestyle choices are personal and family histories of colorectal cancer or adenomatous polyps, having type 2 diabetes, possessing an inherited syndrome, such as Lynch Syndrome, and certain racial and ethnic backgrounds. In addition, Dr. Boccia notes that a personal history of inflammatory bowel disease may increase the risk for developing colorectal cancer. “Patients with ulcerative colitis have to be screened very frequently for colon cancer,” Dr. Boccia elucidates, “because of that high predisposition.”

 

Common CRC Treatments

“For early stage colorectal cancer, the treatment of choice is surgery,” says Dr. Boccia. In this stage, a group of abnormal cells, referred to as carcinoma in situ (CIS), can be removed by a polypectomy, or a part of the colon can be removed via a partial colectomy. Once the cancer has penetrated the wall of the colon and perhaps even grown into nearby tissue, patients of RCCA Maryland will typically undergo active surveillance – although other treatment options are offered to those with high-risk tumors, says Dr. Boccia.

Once the cancer has reached Stage III, patients are generally offered a form of chemotherapy for roughly six weeks. “FOLFOX is the adjuvant therapy of choice,” says Dr. Boccia, “and that we know will lower the incidence of recurrence by about 40-50%.” For Stage IV diseases, which make up about 20% of the cases that RCCA Maryland sees each year, chemotherapy, targeted therapy and even immunotherapy can be used to offer aggressive treatment. If they no longer respond to a particular drug, patients will be introduced to a new regimen.

In regards to new research and treatment options, Dr. Boccia concludes, “I have 50 to 60 clinical trials open at all times in the center, so we’re always looking actively for good, cutting-edge therapies and offering those to our patients.”

 

If you or someone you love has been diagnosed with colorectal cancer, schedule an appointment at one of RCCA’s 29 locations in New Jersey, Maryland or Connecticut for personalized, professional care.

Molecular Testing: Tailoring Treatment by Targeting Pathways

Phillip D. Reid, MD

 

What is molecular testing? How it is used in cancer care?

A.  As we learn how to treat specific subtypes of cancer more accurately, molecular testing, molecular medicine and molecular diagnostics are becoming more prominent in oncology.

In the past, once a cancer was diagnosed, we determined the organ where it started, how much cancer was in the body and where it was. We have since discovered many pathways through which a cancer develops. We now need to know not only the stage, type and origin of cancer, but also the pathway through which it developed and then target that pathway.

 

How does the pathway concept affect therapy selection?

A.  It enhances our ability to treat the cancer, but we now need extra testing on a patient’s particular cancer cells. The great thing about molecular testing is we get an answer specific for the individual, not just for everyone, for example, with lung cancer. But it does require more time for us to find the pathway. From the patient’s standpoint, diagnosis and stage are obtained, and then sometimes we have to send off the cancer cells for extra testing, which increases the time between diagnosis and treatment. But ultimately, a better sense is provided of what drug to use and when to use it, and there’s a much greater likelihood of devising specific, effective treatment.

 

For which types of cancer should molecular testing be used?

A.  Molecular testing has revolutionized every major cancer diagnosis. Patients with lung and breast cancer are the best candidates, but molecular testing also is useful in colon cancer, head-and-neck and bladder cancer, and some leukemias and myelomas.

 

What have been the main developments over the last two to three years with molecular testing?

A.  It’s becoming easier and more standardized to get molecular testing done. A patient receives a diagnosis and his or her cancer is sent off to a lab, which evaluates all known pathways for that cancer. A specific result is received. As the patient receives therapy, sometimes the cancer changes and he or she may need a second or third biopsy one to three years after the initial diagnosis to see what’s changed in the cancer, and then the treatment changes based on that result. We now see cancer as a moving target as it progresses, and we have to recalibrate every few years so that we’re shooting that target correctly.

 

What should patients know about molecular testing before proceeding?

A.  After a patient receives his or her staging diagnosis, the next question is, “What subtype of lung cancer do I have and what pathway did the cancer use to develop?” The patient needs to have patience, as that extra information may not arrive for two to four weeks, but that information can increase the chances of treatment success.

Also ask about clinical trials of cancer medications before beginning therapy, because we often know about upcoming medications that are effective and possibly better than what we have right now.

Colorectal Cancer Trends and Treatment

Ralph V. Boccia, MD, a cancer specialist at RCCA Maryland, provides some insight into recent colorectal cancer trends and treatments that are giving new hope to doctors, researchers and patients nationwide. Overall, Dr. Boccia finds much to be encouraged by, but also points to the need for awareness of a concerning development in the field of colorectal cancer.

 

How Far We’ve Come and Where We’re Going

As a whole, colorectal cancer rates have been dropping. According to the National Cancer Institute and Centers for Disease Control and Prevention, Maryland alone has seen a 2.6% decrease in the amount of new CRC patients diagnosed over a five-year period. Dr. Boccia believes this trend can be partly attributed to the following:

  • Widespread increase in colonoscopies and other CRC screening methods
  • Early detection and removal of polyps before they become cancerous
  • More cases being diagnosed at an early stage – when the cancer is more responsive to treatment

Despite the good news, it’s still projected that 2,358 Maryland residents will be diagnosed and that 927 people will die from the disease this year, says Dr. Boccia. Doctors have also been noticing an uncharacteristic increase in the amount of younger adults being diagnosed with CRC. Since it typically affects individuals above the age of 50, this emerging demographic has been cause for concern. But Dr. Boccia and his colleagues will continue to conduct research and make further strides in colorectal cancer care to better serve patients of all ages.

 

Current Treatment Options

Surgical innovations, targeted therapies, immunotherapies, chemotherapy and clinical trials are paving the way for more effective CRC solutions. Dr. Boccia explains, “We have a greater ability than ever before to individualize care, and to offer patients multi-modal treatment regimens that employ a variety of mechanisms of action to combat cancer by different means.”

 

Reducing Your Risk

Follow these tips to help reduce your risk for developing colorectal cancer:

  • Maintain a healthy weight
  • Stay physically active
  • Avoid smoking cigarettes and only drink alcohol in moderation
  • Get a CRC screening regularly
  • Consult a physician right away if you experience any CRC symptoms, such as blood in the stool and persistent abdominal pain
  • Manage other conditions that may increase your risk for CRC, like type 2 diabetes, inflammatory bowel disease and adenomatous polyps

 

If you or someone you love has been diagnosed with colorectal cancer, schedule an appointment at one of RCCA’s 29 locations in New Jersey, Maryland or Connecticut for personalized, professional care.

RCCA Earns URAC Accreditation In Specialty Pharmacy

[Hackensack, NJ] – RCCA is proud to announce that it has earned URAC accreditation in Specialty Pharmacy. URAC is the independent leader in promoting healthcare quality through accreditation, certification and measurement. By achieving this status, RCCA has demonstrated a comprehensive commitment to quality care, improved processes and better patient outcomes.

 

“URAC Accreditation is a testament to the commitment of delivering the highest level of quality standards to our patients and their caregivers,” said Terrill Jordan, President and CEO of RCCA. ”This type of commitment is the cornerstone of everything we do at RCCA,” he added.

Edward Licitra, MD, PhD, RCCA Chairperson of the Board and RCCA Pharmacy Medical Director and Eileen Peng, PharmD, Director of the RCCA Pharmacy agree that “this new recognition will allow us to continue to provide the highest level of patient care and convenience for the people that need it the most.”

 

“Pharmacy services have never played such an important role in the delivery of care as they do today. RCCA distinguishes itself for having voluntarily undergone a rigorous review of quality standards that earned it URAC accreditation,” said URAC President and CEO Kylanne Green. “Independent URAC accreditation shows RCCA is dedicated to quality and safety, and that it strives for a continual improvement of its services.”

ABOUT RCCA

Regional Cancer Care Associates (RCCA), one of the largest oncology physician networks in the United States, is transforming oncology care by ensuring that cancer patients have access to the highest-quality, most-comprehensive, cutting edge treatments in a compassionate and community-based setting. RCCA includes more than 100 cancer care specialists and is supported by 800 employees at more than 30 care delivery sites, providing care to more than 24,000 new patients annually and over 240,000 existing patients.  For more information visit: http://www.RCCA.com

About URAC

Founded in 1990, URAC is the independent leader in promoting healthcare quality through accreditation, certification and measurement. URAC is a nonprofit organization developing evidence-based measures and standards through inclusive engagement with a range of stakeholders committed to improving the quality of healthcare. Our portfolio of accreditation and certification programs span the healthcare industry, addressing healthcare management, healthcare operations, health plans, pharmacies, telehealth providers, physician practices, and more. URAC accreditation is a symbol of excellence for organizations to showcase their validated commitment to quality and accountability.

For further information, contact:

Mary Lou Salvemini
msalvemini@regionalcancercare.org
(201) 510-0922

RCCA Makes Innovative UnitedHealthcare Cancer Care Program Available to Patients in Maryland

HACKENSACK, N.J., Nov. 22, 2016 /PRNewswire-USNewswire/ — Regional Cancer Care Associates (RCCA) is expanding its cancer care payment initiative with UnitedHealthcare to RCCA patients in Maryland who are covered by UnitedHealthcare benefit plans.

The program, made available at RCCA New Jersey locations in January, rewards physicians for focusing on best treatment practices, quality patient care and better health outcomes. The program pays participating medical oncologists more if they demonstrate superior clinical results and if they reduce the total cost of care.

The episode payment model shifts reimbursement away from the current “fee-for-service” approach that emphasizes volume of care delivered regardless of a patient’s health outcomes. The episode payment is based on the expected cost of a standard treatment regimen for a specific condition, as predetermined by the doctor. Similar payment models have been shown to enhance care coordination and improve health outcomes for patients, while reducing overall costs.

“RCCA has emerged as a leader in delivering the highest-level quality cancer care to our patients,” said Terrill Jordan, RCCA President and CEO. “New payment methodologies like this put patients’ interests at the forefront of cancer treatment. It also results in significant cost savings, which advances efforts across the country to assist in controlling rising health care costs. We are excited to offer this program to our Maryland patient base.”

Lee N. Newcomer, M.D., UnitedHealthcare’s Senior Vice President, Oncology, said: “Our partnership with RCCA marks an important step toward expanded episode payment models and away from the traditional fee-for-service payments for oncology care. We look forward to working with RCCA and others to expand our efforts to identify best practices for treating cancer.”

A study published in the Journal of Oncology Practice has demonstrated that this program reduced overall cancer expenses by more than a third while improving quality outcomes. RCCA is among five oncology practices that have joined the program, which now has a total of more than 650 oncologists. RCCA in New Jersey and now Maryland comprise approximately 100 of these oncologists.

“Value-based cancer care is here. This program will enable Maryland-based RCCA oncologists to continue to provide patient-centered care at the highest level of quality,” said Ralph Boccia, M.D., RCCA Research Deputy Chair and Oncologist in Bethesda and Germantown, Md.

UnitedHealthcare first implemented its episode payment program as a pilot study between October 2009 and December 2012. The pilot study produced a significant reduction in hospitalizations and a 34 percent reduction in total costs while improving quality. Click here to read results of the study.

About RCCA
Regional Cancer Care Associates (RCCA), one of the largest oncology physician networks in the United States, is transforming oncology care by ensuring that cancer patients have access to the highest-quality, most-comprehensive, cutting edge treatments in a compassionate and community-based setting. RCCA includes 100 cancer care specialists and is supported by 700 employees at 27 care delivery sites, providing care to more than 230,000 existing patients in New Jersey, Maryland and Washington DC.  For more information visit: http://www.RCCA.com

Contact:

Mary Lou Salvemini
msalvemini@regionalcancercare.org
(201) 510-0922

REGIONAL CANCER CARE ASSOCIATES AND AETNA FORM ONCOLOGY MEDICAL HOME

REGIONAL CANCER CARE ASSOCIATES AND AETNA FORM ONCOLOGY MEDICAL HOME

— The Patient-Focused Model Supports High-Value Care–

 

Hackensack, NJ, October 12, 2016 — Regional Cancer Care Associates (RCCA) and Aetna (NYSE: AET) announced a collaboration to create an oncology medical home that is designed to improve the care experience for cancer patients.

In the oncology medical home model, teams of cancer specialists collectively provide a patient’s health care when he or she has a cancer diagnosis. The model will give RCCA the responsibility to arrange appropriate care that is continuous and proactive and physicians will be incentivized for improved health, affordability and a better patient experience.

The oncology medical home arrangement will be available to patients at all RCCA locations in New Jersey and Maryland.

“RCCA is excited to partner with Aetna on this program. It aligns with our vision of providing patient centered care close to home,” said Terrill Jordan, RCCA President & CEO. “This partnership will not only enable us to continue the delivery of high quality care through reduced side effects, but will also facilitate cost effective care based on the data Aetna will be sharing,” said Michael Ruiz de Somocurcio, RCCA Vice President of Payer and Provider Collaboration.

The model is part of a strategic direction to transition from fee-for-service medicine to value-based payment. Value-based arrangements are emerging as a solution to address rising health care costs, clinical inefficiency, duplication of services, and access to care. In value-based models, doctors and hospitals are paid for helping to keep people healthy and for improving the health of those who have chronic conditions in an evidence-based, cost-effective way.

“We understand that cancer treatment can be the hardest experience that our members will ever have to go through,” said Daniel Knecht, M.D., M.B.A., Aetna’s Head of Strategy & Planning and Interim Head of Oncology Solutions. “This oncology medical home with RCCA will help provide our members with high-quality care and an optimal patient experience.”

The operating principles of the RCCA and Aetna oncology medical home include:

  • An orientation to the whole person. A personal physician from RCCA will be responsible for providing or arranging all of a patient’s health care needs with other qualified professionals. This includes care for all stages of treatment: preventive services, acute care, chronic care, palliative care and end-of-life care.
  • Evidence-based, personalized medical care. The RCCA team will focus on making treatment decisions based on current medical evidence for each unique disease presentation, patient-specific factors and patient choice using appropriate treatments to improve quality and outcomes.
  • Coordinated and integrated care. Care will be facilitated, across all elements of the health system, to enable Aetna members to get the appropriate care when and where it is needed and wanted, in a culturally and linguistically appropriate manner.
  • Quality and safety. Quality and safety will be a focus of care, including the use of evidence-based medicine, clinical decision support tools and accountability for continuous quality improvement.
  • Enhanced access to care. Care will be available through systems such as open scheduling, expanded hours and new options for communication between Aetna members, their personal physicians and hospital staff.

The oncology medical home arrangement launched in September 2016.

About RCCA

Regional Cancer Care Associates (RCCA), one of the largest oncology physician networks in the United States, is transforming oncology care by ensuring that cancer patients have access to the highest-quality, most-comprehensive, cutting edge treatments in a compassionate and community-based setting. RCCA includes 100 cancer care specialists and is supported by 700 employees at 27 care delivery sites, providing care to more than 23,000 new patients annually and over 230,000 existing patients in New Jersey, Maryland and Washington DC. For more information visit: http://www.RCCA.com.

About Aetna

Aetna is one of the nation’s leading diversified health care benefits companies, serving an estimated 46.3 million people with information and resources to help them make better informed decisions about their health care. Aetna offers a broad range of traditional, voluntary and consumer-directed health insurance products and related services, including medical, pharmacy, dental, behavioral health, group life and disability plans, and medical management capabilities, Medicaid health care management services, workers’ compensation administrative services and health information technology products and services. Aetna’s customers include employer groups, individuals, college students, part-time and hourly workers, health plans, health care providers, governmental units, government-sponsored plans, labor groups and expatriates. For more information, see www.aetna.com and learn about how Aetna is helping to build a healthier world. @AetnaNews

 

###

What Cancer Patients Need To Know About Clinical Trials: Insights From New Jersey Hematologist /Oncologist Seth Berk

Seth Howard Berk, MD, a hematologist and medical oncologist with RCCA, reveals four facts that he shares with his patients when they ask about clinical trials.

First, a drug has been thoroughly tested well before it reaches the clinical trial stage. Pre-clinical trial testing involves looking at a drug’s effects on animals as well as human cells. This stage usually takes years of development. Also, the clinical studies have to be designed and conducted in accordance with rigorous ethical and safety criteria.

He also imparts the importance of not thinking of clinical trials as a last resort in treatment. While trials are typically suited for situations in which traditional therapy methods are not working for a patient, there is more evidence emerging of late-stage trials benefitting the patient when used early in the diagnosis process.

A myth that Dr. Berk debunks is the use of a placebo in cancer treatment. Some cancer patients are resistant to clinical trials because they fear there will be a placebo and they will suffer as a result. He says this is misinformation or something assumed from a patient’s memory of high school or college science experiments. In clinical trials, one group will be administered the trial agent while the other continues to have traditional therapy. There are rarely ever patients receiving zero care.

Lastly, Dr. Berk addresses the importance of clinical trials for cancer patients in general. Because of willing patients participating in more and more trials, doctors and patients can share in a community of knowledge and understanding, and, one day, a cure.

To read more about clinical trials, turn to “What cancer patients need to know about clinical trials: Insights from New Jersey oncologist/hematologist Seth Berk.”

RCCA: Taking Cancer Care To A Higher Level In NJ And Beyond

Edward J. Licitra, MD, PhD, board certified in internal medicine, hematology and medical oncology and chairman of the board of directors of Regional Cancer Care Associates (RCCA), shares some of his thoughts on potential models for a health care delivery reform system. Oncologists at RCCA, totaling 100 physicians, learn from each other’s best practices with the patient’s interest at the forefront. Through RCCA, patients can receive care at home instead of visiting a hospital or clinic. They have set up 27 care delivery sites, providing care to more than 23,000 new patients annually and approximately 230,000 existing patients in New Jersey, Maryland and Washington, D.C.

Another example of a successful care reform case is the Oncology Care Model (OCM) created by Medicare under the Affordable Care Act (ACA). The model questions how to best develop an integrated style of cancer care. It focuses on developing a care model for the future, using data sharing and streamlining economics for patients as well as providers. By digitizing patients’ medical histories and sharing them through hospitals and clinics, this model focuses on simplifying the oncology care process.

Lastly, the OCM utilizes evidence-based-medicine (EBM) practices throughout the entire spectrum of care. EBM produces the best methods regardless of cost, while even reducing cost by eliminating wasteful spending. The OCM focuses on patient-focused, research based therapy tailored to the individual patient.

To learn more about this topic, read “RCCA: Taking cancer care to a higher level in NJ and beyond.”

Targeting Treatments for Chronic Lymphocytic Leukemia

Dr. Joel Silver

 

How do myeloma and chronic lymphocytic leukemia (CLL) develop? What are some risk factors associated with those malignancies?

A. We don’t know what causes CLL. We do know that people in some occupations or with a certain exposure history might be at higher risk, and that CLL generally affects older people. Treatment fortunately is not needed in many cases, but even so our treatment options have evolved based on cytogenetics and next-generation sequencing. We have more ways to assess prognostic features and design more personalized and potentially more effective therapy for people with CLL.

 

What therapies have been successful in treating CLL over the last two to three years?

A. If you can identify a certain kind of CLL, such as IDH-mutated CLL, some of the patients with it can receive a standard chemotherapy regimen called FCR, and they sometimes go into remission indefinitely. It depends on whether the patient is young and healthy enough to tolerate the therapy. That’s a select group, though; you don’t see too many young people with CLL.

Years ago, an effective treatment did not exist for another group of patients with CLL, those with the genetic 17p deletion. In recent years, however, the oral agent ibrutinib has shown effectiveness for CLL in this group. Other therapies now are available for patients who don’t respond to ibrutinib.

 

Where does targeted therapy come into play?

A. In general, “targeted therapy” refers to a treatment based on a particular mutation or pattern. The presence of the genetic 17p deletion in CLL is one example, but this is a bad cytogenetic abnormality for which standard treatments such as chemotherapy haven’t worked. If we can identify a particular mutation, then we can target our therapy and plan treatment that we know will work, instead of going through chemotherapies that are only partially effective or downright ineffective and then finding that the patient is resistant to treatment.

 

Are there side effects or drawbacks to targeted therapy?

A. Everything we do has side effects. The oral agent ibrutinib has been an effective first-line therapy for any type of CLL. Although the agent is specifically for patients with 17p deletion, it has also worked for patients without that genetic feature. While some cardiovascular and bleeding issues have been reported, ibrutinib overall is more tolerable than chemotherapy.

When we medically examine patients with CLL, we always look at a pattern of mutations to try to identify how to treat these people — not so much from an immediate therapeutic standpoint, but to gain knowledge of all these other cytogenetic abnormalities so that eventually, we will find other ways to target those different patterns.

What important points do you address with patients before they begin CLL therapy?

A. Many people with CLL don’t die of their disease, they die with their disease, so I tell patients not to be afraid of the disease itself. Many of the conversations we have with these people, however, revolve around the fact that they have this problem but may never need treatment. “We should follow you because you may need treatment down the line,” I tell them. “If you need treatment, we have many effective therapies.”

 

Do you foresee different therapies for CLL emerging within the next two to three years?

A. A number of medications are on the horizon that will be appropriate for any patient with CLL. For example, venetoclax, which gained FDA approval last year, is indicated for second-line treatment of CLL in patients with the 17p deletion, but I think that agent will be effective for all patients with CLL. As similarly versatile agents are developed, we will have many more treatment options.

Colorectal Cancer Trends in Maryland: A Conversation with Dr. Ralph V. Boccia

As the third most common cancer in the United States, colorectal cancer (CRC) affects about 1 in 20 Americans. However, incidence and death rates for cancer of the colorectum have significantly decreased over the past several decades as a result of increased screening and drastic improvements in treatment. In Maryland alone, approximately 70% of adults over the age of 50 have an up-to-date colorectal cancer screening, helping contribute to the reduction in mortality rates.

Dr. Ralph V. Boccia, an oncology and hematology specialist at Regional Cancer Care Associates (RCCA) in Bethesda and Germantown, Maryland says, “The more colorectal screening we have and the earlier it gets started, the lower the stage that the cancer is typically picked up.” In turn, early detection has led to the state’s lower mortality rates over time.

 

The Benefits Of Increased Screening

According to Dr. Boccia, improving screening rates “affects the stage at which the cancer presents itself and [the patient’s] potential for survival.” Between 2002 and 2010, the percentage of Maryland adults with up-to-date colorectal cancer screenings increased from 64% to 71%. As a result, CRC mortality rates in Maryland decreased considerably among both men and women in that eight-year timeframe. Dr. Boccia explains, “The trend we’ve actually seen – which is that more people are being screened – has resulted in more improvements of overall survival in patients with colorectal cancer.”

However, as colon cancer rates decline in adults 50 years and older, both incidence and death rates are increasing in the under-50 population. “We’re seeing a scary trend of younger patients getting colorectal cancer,” remarks Dr. Boccia, “even down into the 20s.” However, at this point in time, there’s insufficient data to clearly identify the causation behind this trend.

 

Colorectal Cancer Risk Factors

According to a report from the Maryland Department of Health and Mental Hygiene, the incidence rate of colon cancer per 100,000 people in Maryland was 1,174 for men and 1,109 for women in 2012. When looking at new cases of CRC, research shows that incidence may be tied to habits and lifestyles. Among these lifestyle- associated risk factors are being overweight or obese, lack of physical activity, smoking, heavy alcohol use and certain types of diets.

As outlined by the American Cancer Society, other risk factors unrelated to lifestyle choices are personal and family histories of colorectal cancer or adenomatous polyps, having type 2 diabetes, possessing an inherited syndrome, such as Lynch Syndrome, and certain racial and ethnic backgrounds. In addition, Dr. Boccia notes that a personal history of inflammatory bowel disease may increase the risk for developing colorectal cancer. “Patients with ulcerative colitis have to be screened very frequently for colon cancer,” Dr. Boccia elucidates, “because of that high predisposition.”

 

Common CRC Treatments

“For early stage colorectal cancer, the treatment of choice is surgery,” says Dr. Boccia. In this stage, a group of abnormal cells, referred to as carcinoma in situ (CIS), can be removed by a polypectomy, or a part of the colon can be removed via a partial colectomy. Once the cancer has penetrated the wall of the colon and perhaps even grown into nearby tissue, patients of RCCA Maryland will typically undergo active surveillance – although other treatment options are offered to those with high-risk tumors, says Dr. Boccia.

Once the cancer has reached Stage III, patients are generally offered a form of chemotherapy for roughly six weeks. “FOLFOX is the adjuvant therapy of choice,” says Dr. Boccia, “and that we know will lower the incidence of recurrence by about 40-50%.” For Stage IV diseases, which make up about 20% of the cases that RCCA Maryland sees each year, chemotherapy, targeted therapy and even immunotherapy can be used to offer aggressive treatment. If they no longer respond to a particular drug, patients will be introduced to a new regimen.

In regards to new research and treatment options, Dr. Boccia concludes, “I have 50 to 60 clinical trials open at all times in the center, so we’re always looking actively for good, cutting-edge therapies and offering those to our patients.”

 

If you or someone you love has been diagnosed with colorectal cancer, schedule an appointment at one of RCCA’s 29 locations in New Jersey, Maryland or Connecticut for personalized, professional care.

Molecular Testing: Tailoring Treatment by Targeting Pathways

Phillip D. Reid, MD

 

What is molecular testing? How it is used in cancer care?

A.  As we learn how to treat specific subtypes of cancer more accurately, molecular testing, molecular medicine and molecular diagnostics are becoming more prominent in oncology.

In the past, once a cancer was diagnosed, we determined the organ where it started, how much cancer was in the body and where it was. We have since discovered many pathways through which a cancer develops. We now need to know not only the stage, type and origin of cancer, but also the pathway through which it developed and then target that pathway.

 

How does the pathway concept affect therapy selection?

A.  It enhances our ability to treat the cancer, but we now need extra testing on a patient’s particular cancer cells. The great thing about molecular testing is we get an answer specific for the individual, not just for everyone, for example, with lung cancer. But it does require more time for us to find the pathway. From the patient’s standpoint, diagnosis and stage are obtained, and then sometimes we have to send off the cancer cells for extra testing, which increases the time between diagnosis and treatment. But ultimately, a better sense is provided of what drug to use and when to use it, and there’s a much greater likelihood of devising specific, effective treatment.

 

For which types of cancer should molecular testing be used?

A.  Molecular testing has revolutionized every major cancer diagnosis. Patients with lung and breast cancer are the best candidates, but molecular testing also is useful in colon cancer, head-and-neck and bladder cancer, and some leukemias and myelomas.

 

What have been the main developments over the last two to three years with molecular testing?

A.  It’s becoming easier and more standardized to get molecular testing done. A patient receives a diagnosis and his or her cancer is sent off to a lab, which evaluates all known pathways for that cancer. A specific result is received. As the patient receives therapy, sometimes the cancer changes and he or she may need a second or third biopsy one to three years after the initial diagnosis to see what’s changed in the cancer, and then the treatment changes based on that result. We now see cancer as a moving target as it progresses, and we have to recalibrate every few years so that we’re shooting that target correctly.

 

What should patients know about molecular testing before proceeding?

A.  After a patient receives his or her staging diagnosis, the next question is, “What subtype of lung cancer do I have and what pathway did the cancer use to develop?” The patient needs to have patience, as that extra information may not arrive for two to four weeks, but that information can increase the chances of treatment success.

Also ask about clinical trials of cancer medications before beginning therapy, because we often know about upcoming medications that are effective and possibly better than what we have right now.

Colorectal Cancer Trends and Treatment

Ralph V. Boccia, MD, a cancer specialist at RCCA Maryland, provides some insight into recent colorectal cancer trends and treatments that are giving new hope to doctors, researchers and patients nationwide. Overall, Dr. Boccia finds much to be encouraged by, but also points to the need for awareness of a concerning development in the field of colorectal cancer.

 

How Far We’ve Come and Where We’re Going

As a whole, colorectal cancer rates have been dropping. According to the National Cancer Institute and Centers for Disease Control and Prevention, Maryland alone has seen a 2.6% decrease in the amount of new CRC patients diagnosed over a five-year period. Dr. Boccia believes this trend can be partly attributed to the following:

  • Widespread increase in colonoscopies and other CRC screening methods
  • Early detection and removal of polyps before they become cancerous
  • More cases being diagnosed at an early stage – when the cancer is more responsive to treatment

Despite the good news, it’s still projected that 2,358 Maryland residents will be diagnosed and that 927 people will die from the disease this year, says Dr. Boccia. Doctors have also been noticing an uncharacteristic increase in the amount of younger adults being diagnosed with CRC. Since it typically affects individuals above the age of 50, this emerging demographic has been cause for concern. But Dr. Boccia and his colleagues will continue to conduct research and make further strides in colorectal cancer care to better serve patients of all ages.

 

Current Treatment Options

Surgical innovations, targeted therapies, immunotherapies, chemotherapy and clinical trials are paving the way for more effective CRC solutions. Dr. Boccia explains, “We have a greater ability than ever before to individualize care, and to offer patients multi-modal treatment regimens that employ a variety of mechanisms of action to combat cancer by different means.”

 

Reducing Your Risk

Follow these tips to help reduce your risk for developing colorectal cancer:

  • Maintain a healthy weight
  • Stay physically active
  • Avoid smoking cigarettes and only drink alcohol in moderation
  • Get a CRC screening regularly
  • Consult a physician right away if you experience any CRC symptoms, such as blood in the stool and persistent abdominal pain
  • Manage other conditions that may increase your risk for CRC, like type 2 diabetes, inflammatory bowel disease and adenomatous polyps

 

If you or someone you love has been diagnosed with colorectal cancer, schedule an appointment at one of RCCA’s 29 locations in New Jersey, Maryland or Connecticut for personalized, professional care.

RCCA Earns URAC Accreditation In Specialty Pharmacy

[Hackensack, NJ] – RCCA is proud to announce that it has earned URAC accreditation in Specialty Pharmacy. URAC is the independent leader in promoting healthcare quality through accreditation, certification and measurement. By achieving this status, RCCA has demonstrated a comprehensive commitment to quality care, improved processes and better patient outcomes.

 

“URAC Accreditation is a testament to the commitment of delivering the highest level of quality standards to our patients and their caregivers,” said Terrill Jordan, President and CEO of RCCA. ”This type of commitment is the cornerstone of everything we do at RCCA,” he added.

Edward Licitra, MD, PhD, RCCA Chairperson of the Board and RCCA Pharmacy Medical Director and Eileen Peng, PharmD, Director of the RCCA Pharmacy agree that “this new recognition will allow us to continue to provide the highest level of patient care and convenience for the people that need it the most.”

 

“Pharmacy services have never played such an important role in the delivery of care as they do today. RCCA distinguishes itself for having voluntarily undergone a rigorous review of quality standards that earned it URAC accreditation,” said URAC President and CEO Kylanne Green. “Independent URAC accreditation shows RCCA is dedicated to quality and safety, and that it strives for a continual improvement of its services.”

ABOUT RCCA

Regional Cancer Care Associates (RCCA), one of the largest oncology physician networks in the United States, is transforming oncology care by ensuring that cancer patients have access to the highest-quality, most-comprehensive, cutting edge treatments in a compassionate and community-based setting. RCCA includes more than 100 cancer care specialists and is supported by 800 employees at more than 30 care delivery sites, providing care to more than 24,000 new patients annually and over 240,000 existing patients.  For more information visit: http://www.RCCA.com

About URAC

Founded in 1990, URAC is the independent leader in promoting healthcare quality through accreditation, certification and measurement. URAC is a nonprofit organization developing evidence-based measures and standards through inclusive engagement with a range of stakeholders committed to improving the quality of healthcare. Our portfolio of accreditation and certification programs span the healthcare industry, addressing healthcare management, healthcare operations, health plans, pharmacies, telehealth providers, physician practices, and more. URAC accreditation is a symbol of excellence for organizations to showcase their validated commitment to quality and accountability.

For further information, contact:

Mary Lou Salvemini
msalvemini@regionalcancercare.org
(201) 510-0922

RCCA Makes Innovative UnitedHealthcare Cancer Care Program Available to Patients in Maryland

HACKENSACK, N.J., Nov. 22, 2016 /PRNewswire-USNewswire/ — Regional Cancer Care Associates (RCCA) is expanding its cancer care payment initiative with UnitedHealthcare to RCCA patients in Maryland who are covered by UnitedHealthcare benefit plans.

The program, made available at RCCA New Jersey locations in January, rewards physicians for focusing on best treatment practices, quality patient care and better health outcomes. The program pays participating medical oncologists more if they demonstrate superior clinical results and if they reduce the total cost of care.

The episode payment model shifts reimbursement away from the current “fee-for-service” approach that emphasizes volume of care delivered regardless of a patient’s health outcomes. The episode payment is based on the expected cost of a standard treatment regimen for a specific condition, as predetermined by the doctor. Similar payment models have been shown to enhance care coordination and improve health outcomes for patients, while reducing overall costs.

“RCCA has emerged as a leader in delivering the highest-level quality cancer care to our patients,” said Terrill Jordan, RCCA President and CEO. “New payment methodologies like this put patients’ interests at the forefront of cancer treatment. It also results in significant cost savings, which advances efforts across the country to assist in controlling rising health care costs. We are excited to offer this program to our Maryland patient base.”

Lee N. Newcomer, M.D., UnitedHealthcare’s Senior Vice President, Oncology, said: “Our partnership with RCCA marks an important step toward expanded episode payment models and away from the traditional fee-for-service payments for oncology care. We look forward to working with RCCA and others to expand our efforts to identify best practices for treating cancer.”

A study published in the Journal of Oncology Practice has demonstrated that this program reduced overall cancer expenses by more than a third while improving quality outcomes. RCCA is among five oncology practices that have joined the program, which now has a total of more than 650 oncologists. RCCA in New Jersey and now Maryland comprise approximately 100 of these oncologists.

“Value-based cancer care is here. This program will enable Maryland-based RCCA oncologists to continue to provide patient-centered care at the highest level of quality,” said Ralph Boccia, M.D., RCCA Research Deputy Chair and Oncologist in Bethesda and Germantown, Md.

UnitedHealthcare first implemented its episode payment program as a pilot study between October 2009 and December 2012. The pilot study produced a significant reduction in hospitalizations and a 34 percent reduction in total costs while improving quality. Click here to read results of the study.

About RCCA
Regional Cancer Care Associates (RCCA), one of the largest oncology physician networks in the United States, is transforming oncology care by ensuring that cancer patients have access to the highest-quality, most-comprehensive, cutting edge treatments in a compassionate and community-based setting. RCCA includes 100 cancer care specialists and is supported by 700 employees at 27 care delivery sites, providing care to more than 230,000 existing patients in New Jersey, Maryland and Washington DC.  For more information visit: http://www.RCCA.com

Contact:

Mary Lou Salvemini
msalvemini@regionalcancercare.org
(201) 510-0922

REGIONAL CANCER CARE ASSOCIATES AND AETNA FORM ONCOLOGY MEDICAL HOME

REGIONAL CANCER CARE ASSOCIATES AND AETNA FORM ONCOLOGY MEDICAL HOME

— The Patient-Focused Model Supports High-Value Care–

 

Hackensack, NJ, October 12, 2016 — Regional Cancer Care Associates (RCCA) and Aetna (NYSE: AET) announced a collaboration to create an oncology medical home that is designed to improve the care experience for cancer patients.

In the oncology medical home model, teams of cancer specialists collectively provide a patient’s health care when he or she has a cancer diagnosis. The model will give RCCA the responsibility to arrange appropriate care that is continuous and proactive and physicians will be incentivized for improved health, affordability and a better patient experience.

The oncology medical home arrangement will be available to patients at all RCCA locations in New Jersey and Maryland.

“RCCA is excited to partner with Aetna on this program. It aligns with our vision of providing patient centered care close to home,” said Terrill Jordan, RCCA President & CEO. “This partnership will not only enable us to continue the delivery of high quality care through reduced side effects, but will also facilitate cost effective care based on the data Aetna will be sharing,” said Michael Ruiz de Somocurcio, RCCA Vice President of Payer and Provider Collaboration.

The model is part of a strategic direction to transition from fee-for-service medicine to value-based payment. Value-based arrangements are emerging as a solution to address rising health care costs, clinical inefficiency, duplication of services, and access to care. In value-based models, doctors and hospitals are paid for helping to keep people healthy and for improving the health of those who have chronic conditions in an evidence-based, cost-effective way.

“We understand that cancer treatment can be the hardest experience that our members will ever have to go through,” said Daniel Knecht, M.D., M.B.A., Aetna’s Head of Strategy & Planning and Interim Head of Oncology Solutions. “This oncology medical home with RCCA will help provide our members with high-quality care and an optimal patient experience.”

The operating principles of the RCCA and Aetna oncology medical home include:

  • An orientation to the whole person. A personal physician from RCCA will be responsible for providing or arranging all of a patient’s health care needs with other qualified professionals. This includes care for all stages of treatment: preventive services, acute care, chronic care, palliative care and end-of-life care.
  • Evidence-based, personalized medical care. The RCCA team will focus on making treatment decisions based on current medical evidence for each unique disease presentation, patient-specific factors and patient choice using appropriate treatments to improve quality and outcomes.
  • Coordinated and integrated care. Care will be facilitated, across all elements of the health system, to enable Aetna members to get the appropriate care when and where it is needed and wanted, in a culturally and linguistically appropriate manner.
  • Quality and safety. Quality and safety will be a focus of care, including the use of evidence-based medicine, clinical decision support tools and accountability for continuous quality improvement.
  • Enhanced access to care. Care will be available through systems such as open scheduling, expanded hours and new options for communication between Aetna members, their personal physicians and hospital staff.

The oncology medical home arrangement launched in September 2016.

About RCCA

Regional Cancer Care Associates (RCCA), one of the largest oncology physician networks in the United States, is transforming oncology care by ensuring that cancer patients have access to the highest-quality, most-comprehensive, cutting edge treatments in a compassionate and community-based setting. RCCA includes 100 cancer care specialists and is supported by 700 employees at 27 care delivery sites, providing care to more than 23,000 new patients annually and over 230,000 existing patients in New Jersey, Maryland and Washington DC. For more information visit: http://www.RCCA.com.

About Aetna

Aetna is one of the nation’s leading diversified health care benefits companies, serving an estimated 46.3 million people with information and resources to help them make better informed decisions about their health care. Aetna offers a broad range of traditional, voluntary and consumer-directed health insurance products and related services, including medical, pharmacy, dental, behavioral health, group life and disability plans, and medical management capabilities, Medicaid health care management services, workers’ compensation administrative services and health information technology products and services. Aetna’s customers include employer groups, individuals, college students, part-time and hourly workers, health plans, health care providers, governmental units, government-sponsored plans, labor groups and expatriates. For more information, see www.aetna.com and learn about how Aetna is helping to build a healthier world. @AetnaNews

 

###

What Cancer Patients Need To Know About Clinical Trials: Insights From New Jersey Hematologist /Oncologist Seth Berk

Seth Howard Berk, MD, a hematologist and medical oncologist with RCCA, reveals four facts that he shares with his patients when they ask about clinical trials.

First, a drug has been thoroughly tested well before it reaches the clinical trial stage. Pre-clinical trial testing involves looking at a drug’s effects on animals as well as human cells. This stage usually takes years of development. Also, the clinical studies have to be designed and conducted in accordance with rigorous ethical and safety criteria.

He also imparts the importance of not thinking of clinical trials as a last resort in treatment. While trials are typically suited for situations in which traditional therapy methods are not working for a patient, there is more evidence emerging of late-stage trials benefitting the patient when used early in the diagnosis process.

A myth that Dr. Berk debunks is the use of a placebo in cancer treatment. Some cancer patients are resistant to clinical trials because they fear there will be a placebo and they will suffer as a result. He says this is misinformation or something assumed from a patient’s memory of high school or college science experiments. In clinical trials, one group will be administered the trial agent while the other continues to have traditional therapy. There are rarely ever patients receiving zero care.

Lastly, Dr. Berk addresses the importance of clinical trials for cancer patients in general. Because of willing patients participating in more and more trials, doctors and patients can share in a community of knowledge and understanding, and, one day, a cure.

To read more about clinical trials, turn to “What cancer patients need to know about clinical trials: Insights from New Jersey oncologist/hematologist Seth Berk.”

RCCA: Taking Cancer Care To A Higher Level In NJ And Beyond

Edward J. Licitra, MD, PhD, board certified in internal medicine, hematology and medical oncology and chairman of the board of directors of Regional Cancer Care Associates (RCCA), shares some of his thoughts on potential models for a health care delivery reform system. Oncologists at RCCA, totaling 100 physicians, learn from each other’s best practices with the patient’s interest at the forefront. Through RCCA, patients can receive care at home instead of visiting a hospital or clinic. They have set up 27 care delivery sites, providing care to more than 23,000 new patients annually and approximately 230,000 existing patients in New Jersey, Maryland and Washington, D.C.

Another example of a successful care reform case is the Oncology Care Model (OCM) created by Medicare under the Affordable Care Act (ACA). The model questions how to best develop an integrated style of cancer care. It focuses on developing a care model for the future, using data sharing and streamlining economics for patients as well as providers. By digitizing patients’ medical histories and sharing them through hospitals and clinics, this model focuses on simplifying the oncology care process.

Lastly, the OCM utilizes evidence-based-medicine (EBM) practices throughout the entire spectrum of care. EBM produces the best methods regardless of cost, while even reducing cost by eliminating wasteful spending. The OCM focuses on patient-focused, research based therapy tailored to the individual patient.

To learn more about this topic, read “RCCA: Taking cancer care to a higher level in NJ and beyond.”

Targeting Treatments for Chronic Lymphocytic Leukemia

Dr. Joel Silver

 

How do myeloma and chronic lymphocytic leukemia (CLL) develop? What are some risk factors associated with those malignancies?

A. We don’t know what causes CLL. We do know that people in some occupations or with a certain exposure history might be at higher risk, and that CLL generally affects older people. Treatment fortunately is not needed in many cases, but even so our treatment options have evolved based on cytogenetics and next-generation sequencing. We have more ways to assess prognostic features and design more personalized and potentially more effective therapy for people with CLL.

 

What therapies have been successful in treating CLL over the last two to three years?

A. If you can identify a certain kind of CLL, such as IDH-mutated CLL, some of the patients with it can receive a standard chemotherapy regimen called FCR, and they sometimes go into remission indefinitely. It depends on whether the patient is young and healthy enough to tolerate the therapy. That’s a select group, though; you don’t see too many young people with CLL.

Years ago, an effective treatment did not exist for another group of patients with CLL, those with the genetic 17p deletion. In recent years, however, the oral agent ibrutinib has shown effectiveness for CLL in this group. Other therapies now are available for patients who don’t respond to ibrutinib.

 

Where does targeted therapy come into play?

A. In general, “targeted therapy” refers to a treatment based on a particular mutation or pattern. The presence of the genetic 17p deletion in CLL is one example, but this is a bad cytogenetic abnormality for which standard treatments such as chemotherapy haven’t worked. If we can identify a particular mutation, then we can target our therapy and plan treatment that we know will work, instead of going through chemotherapies that are only partially effective or downright ineffective and then finding that the patient is resistant to treatment.

 

Are there side effects or drawbacks to targeted therapy?

A. Everything we do has side effects. The oral agent ibrutinib has been an effective first-line therapy for any type of CLL. Although the agent is specifically for patients with 17p deletion, it has also worked for patients without that genetic feature. While some cardiovascular and bleeding issues have been reported, ibrutinib overall is more tolerable than chemotherapy.

When we medically examine patients with CLL, we always look at a pattern of mutations to try to identify how to treat these people — not so much from an immediate therapeutic standpoint, but to gain knowledge of all these other cytogenetic abnormalities so that eventually, we will find other ways to target those different patterns.

What important points do you address with patients before they begin CLL therapy?

A. Many people with CLL don’t die of their disease, they die with their disease, so I tell patients not to be afraid of the disease itself. Many of the conversations we have with these people, however, revolve around the fact that they have this problem but may never need treatment. “We should follow you because you may need treatment down the line,” I tell them. “If you need treatment, we have many effective therapies.”

 

Do you foresee different therapies for CLL emerging within the next two to three years?

A. A number of medications are on the horizon that will be appropriate for any patient with CLL. For example, venetoclax, which gained FDA approval last year, is indicated for second-line treatment of CLL in patients with the 17p deletion, but I think that agent will be effective for all patients with CLL. As similarly versatile agents are developed, we will have many more treatment options.

Colorectal Cancer Trends in Maryland: A Conversation with Dr. Ralph V. Boccia

As the third most common cancer in the United States, colorectal cancer (CRC) affects about 1 in 20 Americans. However, incidence and death rates for cancer of the colorectum have significantly decreased over the past several decades as a result of increased screening and drastic improvements in treatment. In Maryland alone, approximately 70% of adults over the age of 50 have an up-to-date colorectal cancer screening, helping contribute to the reduction in mortality rates.

Dr. Ralph V. Boccia, an oncology and hematology specialist at Regional Cancer Care Associates (RCCA) in Bethesda and Germantown, Maryland says, “The more colorectal screening we have and the earlier it gets started, the lower the stage that the cancer is typically picked up.” In turn, early detection has led to the state’s lower mortality rates over time.

 

The Benefits Of Increased Screening

According to Dr. Boccia, improving screening rates “affects the stage at which the cancer presents itself and [the patient’s] potential for survival.” Between 2002 and 2010, the percentage of Maryland adults with up-to-date colorectal cancer screenings increased from 64% to 71%. As a result, CRC mortality rates in Maryland decreased considerably among both men and women in that eight-year timeframe. Dr. Boccia explains, “The trend we’ve actually seen – which is that more people are being screened – has resulted in more improvements of overall survival in patients with colorectal cancer.”

However, as colon cancer rates decline in adults 50 years and older, both incidence and death rates are increasing in the under-50 population. “We’re seeing a scary trend of younger patients getting colorectal cancer,” remarks Dr. Boccia, “even down into the 20s.” However, at this point in time, there’s insufficient data to clearly identify the causation behind this trend.

 

Colorectal Cancer Risk Factors

According to a report from the Maryland Department of Health and Mental Hygiene, the incidence rate of colon cancer per 100,000 people in Maryland was 1,174 for men and 1,109 for women in 2012. When looking at new cases of CRC, research shows that incidence may be tied to habits and lifestyles. Among these lifestyle- associated risk factors are being overweight or obese, lack of physical activity, smoking, heavy alcohol use and certain types of diets.

As outlined by the American Cancer Society, other risk factors unrelated to lifestyle choices are personal and family histories of colorectal cancer or adenomatous polyps, having type 2 diabetes, possessing an inherited syndrome, such as Lynch Syndrome, and certain racial and ethnic backgrounds. In addition, Dr. Boccia notes that a personal history of inflammatory bowel disease may increase the risk for developing colorectal cancer. “Patients with ulcerative colitis have to be screened very frequently for colon cancer,” Dr. Boccia elucidates, “because of that high predisposition.”

 

Common CRC Treatments

“For early stage colorectal cancer, the treatment of choice is surgery,” says Dr. Boccia. In this stage, a group of abnormal cells, referred to as carcinoma in situ (CIS), can be removed by a polypectomy, or a part of the colon can be removed via a partial colectomy. Once the cancer has penetrated the wall of the colon and perhaps even grown into nearby tissue, patients of RCCA Maryland will typically undergo active surveillance – although other treatment options are offered to those with high-risk tumors, says Dr. Boccia.

Once the cancer has reached Stage III, patients are generally offered a form of chemotherapy for roughly six weeks. “FOLFOX is the adjuvant therapy of choice,” says Dr. Boccia, “and that we know will lower the incidence of recurrence by about 40-50%.” For Stage IV diseases, which make up about 20% of the cases that RCCA Maryland sees each year, chemotherapy, targeted therapy and even immunotherapy can be used to offer aggressive treatment. If they no longer respond to a particular drug, patients will be introduced to a new regimen.

In regards to new research and treatment options, Dr. Boccia concludes, “I have 50 to 60 clinical trials open at all times in the center, so we’re always looking actively for good, cutting-edge therapies and offering those to our patients.”

 

If you or someone you love has been diagnosed with colorectal cancer, schedule an appointment at one of RCCA’s 29 locations in New Jersey, Maryland or Connecticut for personalized, professional care.

Molecular Testing: Tailoring Treatment by Targeting Pathways

Phillip D. Reid, MD

 

What is molecular testing? How it is used in cancer care?

A.  As we learn how to treat specific subtypes of cancer more accurately, molecular testing, molecular medicine and molecular diagnostics are becoming more prominent in oncology.

In the past, once a cancer was diagnosed, we determined the organ where it started, how much cancer was in the body and where it was. We have since discovered many pathways through which a cancer develops. We now need to know not only the stage, type and origin of cancer, but also the pathway through which it developed and then target that pathway.

 

How does the pathway concept affect therapy selection?

A.  It enhances our ability to treat the cancer, but we now need extra testing on a patient’s particular cancer cells. The great thing about molecular testing is we get an answer specific for the individual, not just for everyone, for example, with lung cancer. But it does require more time for us to find the pathway. From the patient’s standpoint, diagnosis and stage are obtained, and then sometimes we have to send off the cancer cells for extra testing, which increases the time between diagnosis and treatment. But ultimately, a better sense is provided of what drug to use and when to use it, and there’s a much greater likelihood of devising specific, effective treatment.

 

For which types of cancer should molecular testing be used?

A.  Molecular testing has revolutionized every major cancer diagnosis. Patients with lung and breast cancer are the best candidates, but molecular testing also is useful in colon cancer, head-and-neck and bladder cancer, and some leukemias and myelomas.

 

What have been the main developments over the last two to three years with molecular testing?

A.  It’s becoming easier and more standardized to get molecular testing done. A patient receives a diagnosis and his or her cancer is sent off to a lab, which evaluates all known pathways for that cancer. A specific result is received. As the patient receives therapy, sometimes the cancer changes and he or she may need a second or third biopsy one to three years after the initial diagnosis to see what’s changed in the cancer, and then the treatment changes based on that result. We now see cancer as a moving target as it progresses, and we have to recalibrate every few years so that we’re shooting that target correctly.

 

What should patients know about molecular testing before proceeding?

A.  After a patient receives his or her staging diagnosis, the next question is, “What subtype of lung cancer do I have and what pathway did the cancer use to develop?” The patient needs to have patience, as that extra information may not arrive for two to four weeks, but that information can increase the chances of treatment success.

Also ask about clinical trials of cancer medications before beginning therapy, because we often know about upcoming medications that are effective and possibly better than what we have right now.

Colorectal Cancer Trends and Treatment

Ralph V. Boccia, MD, a cancer specialist at RCCA Maryland, provides some insight into recent colorectal cancer trends and treatments that are giving new hope to doctors, researchers and patients nationwide. Overall, Dr. Boccia finds much to be encouraged by, but also points to the need for awareness of a concerning development in the field of colorectal cancer.

 

How Far We’ve Come and Where We’re Going

As a whole, colorectal cancer rates have been dropping. According to the National Cancer Institute and Centers for Disease Control and Prevention, Maryland alone has seen a 2.6% decrease in the amount of new CRC patients diagnosed over a five-year period. Dr. Boccia believes this trend can be partly attributed to the following:

  • Widespread increase in colonoscopies and other CRC screening methods
  • Early detection and removal of polyps before they become cancerous
  • More cases being diagnosed at an early stage – when the cancer is more responsive to treatment

Despite the good news, it’s still projected that 2,358 Maryland residents will be diagnosed and that 927 people will die from the disease this year, says Dr. Boccia. Doctors have also been noticing an uncharacteristic increase in the amount of younger adults being diagnosed with CRC. Since it typically affects individuals above the age of 50, this emerging demographic has been cause for concern. But Dr. Boccia and his colleagues will continue to conduct research and make further strides in colorectal cancer care to better serve patients of all ages.

 

Current Treatment Options

Surgical innovations, targeted therapies, immunotherapies, chemotherapy and clinical trials are paving the way for more effective CRC solutions. Dr. Boccia explains, “We have a greater ability than ever before to individualize care, and to offer patients multi-modal treatment regimens that employ a variety of mechanisms of action to combat cancer by different means.”

 

Reducing Your Risk

Follow these tips to help reduce your risk for developing colorectal cancer:

  • Maintain a healthy weight
  • Stay physically active
  • Avoid smoking cigarettes and only drink alcohol in moderation
  • Get a CRC screening regularly
  • Consult a physician right away if you experience any CRC symptoms, such as blood in the stool and persistent abdominal pain
  • Manage other conditions that may increase your risk for CRC, like type 2 diabetes, inflammatory bowel disease and adenomatous polyps

 

If you or someone you love has been diagnosed with colorectal cancer, schedule an appointment at one of RCCA’s 29 locations in New Jersey, Maryland or Connecticut for personalized, professional care.

RCCA Earns URAC Accreditation In Specialty Pharmacy

[Hackensack, NJ] – RCCA is proud to announce that it has earned URAC accreditation in Specialty Pharmacy. URAC is the independent leader in promoting healthcare quality through accreditation, certification and measurement. By achieving this status, RCCA has demonstrated a comprehensive commitment to quality care, improved processes and better patient outcomes.

 

“URAC Accreditation is a testament to the commitment of delivering the highest level of quality standards to our patients and their caregivers,” said Terrill Jordan, President and CEO of RCCA. ”This type of commitment is the cornerstone of everything we do at RCCA,” he added.

Edward Licitra, MD, PhD, RCCA Chairperson of the Board and RCCA Pharmacy Medical Director and Eileen Peng, PharmD, Director of the RCCA Pharmacy agree that “this new recognition will allow us to continue to provide the highest level of patient care and convenience for the people that need it the most.”

 

“Pharmacy services have never played such an important role in the delivery of care as they do today. RCCA distinguishes itself for having voluntarily undergone a rigorous review of quality standards that earned it URAC accreditation,” said URAC President and CEO Kylanne Green. “Independent URAC accreditation shows RCCA is dedicated to quality and safety, and that it strives for a continual improvement of its services.”

ABOUT RCCA

Regional Cancer Care Associates (RCCA), one of the largest oncology physician networks in the United States, is transforming oncology care by ensuring that cancer patients have access to the highest-quality, most-comprehensive, cutting edge treatments in a compassionate and community-based setting. RCCA includes more than 100 cancer care specialists and is supported by 800 employees at more than 30 care delivery sites, providing care to more than 24,000 new patients annually and over 240,000 existing patients.  For more information visit: http://www.RCCA.com

About URAC

Founded in 1990, URAC is the independent leader in promoting healthcare quality through accreditation, certification and measurement. URAC is a nonprofit organization developing evidence-based measures and standards through inclusive engagement with a range of stakeholders committed to improving the quality of healthcare. Our portfolio of accreditation and certification programs span the healthcare industry, addressing healthcare management, healthcare operations, health plans, pharmacies, telehealth providers, physician practices, and more. URAC accreditation is a symbol of excellence for organizations to showcase their validated commitment to quality and accountability.

For further information, contact:

Mary Lou Salvemini
msalvemini@regionalcancercare.org
(201) 510-0922

RCCA Makes Innovative UnitedHealthcare Cancer Care Program Available to Patients in Maryland

HACKENSACK, N.J., Nov. 22, 2016 /PRNewswire-USNewswire/ — Regional Cancer Care Associates (RCCA) is expanding its cancer care payment initiative with UnitedHealthcare to RCCA patients in Maryland who are covered by UnitedHealthcare benefit plans.

The program, made available at RCCA New Jersey locations in January, rewards physicians for focusing on best treatment practices, quality patient care and better health outcomes. The program pays participating medical oncologists more if they demonstrate superior clinical results and if they reduce the total cost of care.

The episode payment model shifts reimbursement away from the current “fee-for-service” approach that emphasizes volume of care delivered regardless of a patient’s health outcomes. The episode payment is based on the expected cost of a standard treatment regimen for a specific condition, as predetermined by the doctor. Similar payment models have been shown to enhance care coordination and improve health outcomes for patients, while reducing overall costs.

“RCCA has emerged as a leader in delivering the highest-level quality cancer care to our patients,” said Terrill Jordan, RCCA President and CEO. “New payment methodologies like this put patients’ interests at the forefront of cancer treatment. It also results in significant cost savings, which advances efforts across the country to assist in controlling rising health care costs. We are excited to offer this program to our Maryland patient base.”

Lee N. Newcomer, M.D., UnitedHealthcare’s Senior Vice President, Oncology, said: “Our partnership with RCCA marks an important step toward expanded episode payment models and away from the traditional fee-for-service payments for oncology care. We look forward to working with RCCA and others to expand our efforts to identify best practices for treating cancer.”

A study published in the Journal of Oncology Practice has demonstrated that this program reduced overall cancer expenses by more than a third while improving quality outcomes. RCCA is among five oncology practices that have joined the program, which now has a total of more than 650 oncologists. RCCA in New Jersey and now Maryland comprise approximately 100 of these oncologists.

“Value-based cancer care is here. This program will enable Maryland-based RCCA oncologists to continue to provide patient-centered care at the highest level of quality,” said Ralph Boccia, M.D., RCCA Research Deputy Chair and Oncologist in Bethesda and Germantown, Md.

UnitedHealthcare first implemented its episode payment program as a pilot study between October 2009 and December 2012. The pilot study produced a significant reduction in hospitalizations and a 34 percent reduction in total costs while improving quality. Click here to read results of the study.

About RCCA
Regional Cancer Care Associates (RCCA), one of the largest oncology physician networks in the United States, is transforming oncology care by ensuring that cancer patients have access to the highest-quality, most-comprehensive, cutting edge treatments in a compassionate and community-based setting. RCCA includes 100 cancer care specialists and is supported by 700 employees at 27 care delivery sites, providing care to more than 230,000 existing patients in New Jersey, Maryland and Washington DC.  For more information visit: http://www.RCCA.com

Contact:

Mary Lou Salvemini
msalvemini@regionalcancercare.org
(201) 510-0922

REGIONAL CANCER CARE ASSOCIATES AND AETNA FORM ONCOLOGY MEDICAL HOME

REGIONAL CANCER CARE ASSOCIATES AND AETNA FORM ONCOLOGY MEDICAL HOME

— The Patient-Focused Model Supports High-Value Care–

 

Hackensack, NJ, October 12, 2016 — Regional Cancer Care Associates (RCCA) and Aetna (NYSE: AET) announced a collaboration to create an oncology medical home that is designed to improve the care experience for cancer patients.

In the oncology medical home model, teams of cancer specialists collectively provide a patient’s health care when he or she has a cancer diagnosis. The model will give RCCA the responsibility to arrange appropriate care that is continuous and proactive and physicians will be incentivized for improved health, affordability and a better patient experience.

The oncology medical home arrangement will be available to patients at all RCCA locations in New Jersey and Maryland.

“RCCA is excited to partner with Aetna on this program. It aligns with our vision of providing patient centered care close to home,” said Terrill Jordan, RCCA President & CEO. “This partnership will not only enable us to continue the delivery of high quality care through reduced side effects, but will also facilitate cost effective care based on the data Aetna will be sharing,” said Michael Ruiz de Somocurcio, RCCA Vice President of Payer and Provider Collaboration.

The model is part of a strategic direction to transition from fee-for-service medicine to value-based payment. Value-based arrangements are emerging as a solution to address rising health care costs, clinical inefficiency, duplication of services, and access to care. In value-based models, doctors and hospitals are paid for helping to keep people healthy and for improving the health of those who have chronic conditions in an evidence-based, cost-effective way.

“We understand that cancer treatment can be the hardest experience that our members will ever have to go through,” said Daniel Knecht, M.D., M.B.A., Aetna’s Head of Strategy & Planning and Interim Head of Oncology Solutions. “This oncology medical home with RCCA will help provide our members with high-quality care and an optimal patient experience.”

The operating principles of the RCCA and Aetna oncology medical home include:

  • An orientation to the whole person. A personal physician from RCCA will be responsible for providing or arranging all of a patient’s health care needs with other qualified professionals. This includes care for all stages of treatment: preventive services, acute care, chronic care, palliative care and end-of-life care.
  • Evidence-based, personalized medical care. The RCCA team will focus on making treatment decisions based on current medical evidence for each unique disease presentation, patient-specific factors and patient choice using appropriate treatments to improve quality and outcomes.
  • Coordinated and integrated care. Care will be facilitated, across all elements of the health system, to enable Aetna members to get the appropriate care when and where it is needed and wanted, in a culturally and linguistically appropriate manner.
  • Quality and safety. Quality and safety will be a focus of care, including the use of evidence-based medicine, clinical decision support tools and accountability for continuous quality improvement.
  • Enhanced access to care. Care will be available through systems such as open scheduling, expanded hours and new options for communication between Aetna members, their personal physicians and hospital staff.

The oncology medical home arrangement launched in September 2016.

About RCCA

Regional Cancer Care Associates (RCCA), one of the largest oncology physician networks in the United States, is transforming oncology care by ensuring that cancer patients have access to the highest-quality, most-comprehensive, cutting edge treatments in a compassionate and community-based setting. RCCA includes 100 cancer care specialists and is supported by 700 employees at 27 care delivery sites, providing care to more than 23,000 new patients annually and over 230,000 existing patients in New Jersey, Maryland and Washington DC. For more information visit: http://www.RCCA.com.

About Aetna

Aetna is one of the nation’s leading diversified health care benefits companies, serving an estimated 46.3 million people with information and resources to help them make better informed decisions about their health care. Aetna offers a broad range of traditional, voluntary and consumer-directed health insurance products and related services, including medical, pharmacy, dental, behavioral health, group life and disability plans, and medical management capabilities, Medicaid health care management services, workers’ compensation administrative services and health information technology products and services. Aetna’s customers include employer groups, individuals, college students, part-time and hourly workers, health plans, health care providers, governmental units, government-sponsored plans, labor groups and expatriates. For more information, see www.aetna.com and learn about how Aetna is helping to build a healthier world. @AetnaNews

 

###

What Cancer Patients Need To Know About Clinical Trials: Insights From New Jersey Hematologist /Oncologist Seth Berk

Seth Howard Berk, MD, a hematologist and medical oncologist with RCCA, reveals four facts that he shares with his patients when they ask about clinical trials.

First, a drug has been thoroughly tested well before it reaches the clinical trial stage. Pre-clinical trial testing involves looking at a drug’s effects on animals as well as human cells. This stage usually takes years of development. Also, the clinical studies have to be designed and conducted in accordance with rigorous ethical and safety criteria.

He also imparts the importance of not thinking of clinical trials as a last resort in treatment. While trials are typically suited for situations in which traditional therapy methods are not working for a patient, there is more evidence emerging of late-stage trials benefitting the patient when used early in the diagnosis process.

A myth that Dr. Berk debunks is the use of a placebo in cancer treatment. Some cancer patients are resistant to clinical trials because they fear there will be a placebo and they will suffer as a result. He says this is misinformation or something assumed from a patient’s memory of high school or college science experiments. In clinical trials, one group will be administered the trial agent while the other continues to have traditional therapy. There are rarely ever patients receiving zero care.

Lastly, Dr. Berk addresses the importance of clinical trials for cancer patients in general. Because of willing patients participating in more and more trials, doctors and patients can share in a community of knowledge and understanding, and, one day, a cure.

To read more about clinical trials, turn to “What cancer patients need to know about clinical trials: Insights from New Jersey oncologist/hematologist Seth Berk.”

RCCA: Taking Cancer Care To A Higher Level In NJ And Beyond

Edward J. Licitra, MD, PhD, board certified in internal medicine, hematology and medical oncology and chairman of the board of directors of Regional Cancer Care Associates (RCCA), shares some of his thoughts on potential models for a health care delivery reform system. Oncologists at RCCA, totaling 100 physicians, learn from each other’s best practices with the patient’s interest at the forefront. Through RCCA, patients can receive care at home instead of visiting a hospital or clinic. They have set up 27 care delivery sites, providing care to more than 23,000 new patients annually and approximately 230,000 existing patients in New Jersey, Maryland and Washington, D.C.

Another example of a successful care reform case is the Oncology Care Model (OCM) created by Medicare under the Affordable Care Act (ACA). The model questions how to best develop an integrated style of cancer care. It focuses on developing a care model for the future, using data sharing and streamlining economics for patients as well as providers. By digitizing patients’ medical histories and sharing them through hospitals and clinics, this model focuses on simplifying the oncology care process.

Lastly, the OCM utilizes evidence-based-medicine (EBM) practices throughout the entire spectrum of care. EBM produces the best methods regardless of cost, while even reducing cost by eliminating wasteful spending. The OCM focuses on patient-focused, research based therapy tailored to the individual patient.

To learn more about this topic, read “RCCA: Taking cancer care to a higher level in NJ and beyond.”

Targeting Treatments for Chronic Lymphocytic Leukemia

Dr. Joel Silver

 

How do myeloma and chronic lymphocytic leukemia (CLL) develop? What are some risk factors associated with those malignancies?

A. We don’t know what causes CLL. We do know that people in some occupations or with a certain exposure history might be at higher risk, and that CLL generally affects older people. Treatment fortunately is not needed in many cases, but even so our treatment options have evolved based on cytogenetics and next-generation sequencing. We have more ways to assess prognostic features and design more personalized and potentially more effective therapy for people with CLL.

 

What therapies have been successful in treating CLL over the last two to three years?

A. If you can identify a certain kind of CLL, such as IDH-mutated CLL, some of the patients with it can receive a standard chemotherapy regimen called FCR, and they sometimes go into remission indefinitely. It depends on whether the patient is young and healthy enough to tolerate the therapy. That’s a select group, though; you don’t see too many young people with CLL.

Years ago, an effective treatment did not exist for another group of patients with CLL, those with the genetic 17p deletion. In recent years, however, the oral agent ibrutinib has shown effectiveness for CLL in this group. Other therapies now are available for patients who don’t respond to ibrutinib.

 

Where does targeted therapy come into play?

A. In general, “targeted therapy” refers to a treatment based on a particular mutation or pattern. The presence of the genetic 17p deletion in CLL is one example, but this is a bad cytogenetic abnormality for which standard treatments such as chemotherapy haven’t worked. If we can identify a particular mutation, then we can target our therapy and plan treatment that we know will work, instead of going through chemotherapies that are only partially effective or downright ineffective and then finding that the patient is resistant to treatment.

 

Are there side effects or drawbacks to targeted therapy?

A. Everything we do has side effects. The oral agent ibrutinib has been an effective first-line therapy for any type of CLL. Although the agent is specifically for patients with 17p deletion, it has also worked for patients without that genetic feature. While some cardiovascular and bleeding issues have been reported, ibrutinib overall is more tolerable than chemotherapy.

When we medically examine patients with CLL, we always look at a pattern of mutations to try to identify how to treat these people — not so much from an immediate therapeutic standpoint, but to gain knowledge of all these other cytogenetic abnormalities so that eventually, we will find other ways to target those different patterns.

What important points do you address with patients before they begin CLL therapy?

A. Many people with CLL don’t die of their disease, they die with their disease, so I tell patients not to be afraid of the disease itself. Many of the conversations we have with these people, however, revolve around the fact that they have this problem but may never need treatment. “We should follow you because you may need treatment down the line,” I tell them. “If you need treatment, we have many effective therapies.”

 

Do you foresee different therapies for CLL emerging within the next two to three years?

A. A number of medications are on the horizon that will be appropriate for any patient with CLL. For example, venetoclax, which gained FDA approval last year, is indicated for second-line treatment of CLL in patients with the 17p deletion, but I think that agent will be effective for all patients with CLL. As similarly versatile agents are developed, we will have many more treatment options.

Colorectal Cancer Trends in Maryland: A Conversation with Dr. Ralph V. Boccia

As the third most common cancer in the United States, colorectal cancer (CRC) affects about 1 in 20 Americans. However, incidence and death rates for cancer of the colorectum have significantly decreased over the past several decades as a result of increased screening and drastic improvements in treatment. In Maryland alone, approximately 70% of adults over the age of 50 have an up-to-date colorectal cancer screening, helping contribute to the reduction in mortality rates.

Dr. Ralph V. Boccia, an oncology and hematology specialist at Regional Cancer Care Associates (RCCA) in Bethesda and Germantown, Maryland says, “The more colorectal screening we have and the earlier it gets started, the lower the stage that the cancer is typically picked up.” In turn, early detection has led to the state’s lower mortality rates over time.

 

The Benefits Of Increased Screening

According to Dr. Boccia, improving screening rates “affects the stage at which the cancer presents itself and [the patient’s] potential for survival.” Between 2002 and 2010, the percentage of Maryland adults with up-to-date colorectal cancer screenings increased from 64% to 71%. As a result, CRC mortality rates in Maryland decreased considerably among both men and women in that eight-year timeframe. Dr. Boccia explains, “The trend we’ve actually seen – which is that more people are being screened – has resulted in more improvements of overall survival in patients with colorectal cancer.”

However, as colon cancer rates decline in adults 50 years and older, both incidence and death rates are increasing in the under-50 population. “We’re seeing a scary trend of younger patients getting colorectal cancer,” remarks Dr. Boccia, “even down into the 20s.” However, at this point in time, there’s insufficient data to clearly identify the causation behind this trend.

 

Colorectal Cancer Risk Factors

According to a report from the Maryland Department of Health and Mental Hygiene, the incidence rate of colon cancer per 100,000 people in Maryland was 1,174 for men and 1,109 for women in 2012. When looking at new cases of CRC, research shows that incidence may be tied to habits and lifestyles. Among these lifestyle- associated risk factors are being overweight or obese, lack of physical activity, smoking, heavy alcohol use and certain types of diets.

As outlined by the American Cancer Society, other risk factors unrelated to lifestyle choices are personal and family histories of colorectal cancer or adenomatous polyps, having type 2 diabetes, possessing an inherited syndrome, such as Lynch Syndrome, and certain racial and ethnic backgrounds. In addition, Dr. Boccia notes that a personal history of inflammatory bowel disease may increase the risk for developing colorectal cancer. “Patients with ulcerative colitis have to be screened very frequently for colon cancer,” Dr. Boccia elucidates, “because of that high predisposition.”

 

Common CRC Treatments

“For early stage colorectal cancer, the treatment of choice is surgery,” says Dr. Boccia. In this stage, a group of abnormal cells, referred to as carcinoma in situ (CIS), can be removed by a polypectomy, or a part of the colon can be removed via a partial colectomy. Once the cancer has penetrated the wall of the colon and perhaps even grown into nearby tissue, patients of RCCA Maryland will typically undergo active surveillance – although other treatment options are offered to those with high-risk tumors, says Dr. Boccia.

Once the cancer has reached Stage III, patients are generally offered a form of chemotherapy for roughly six weeks. “FOLFOX is the adjuvant therapy of choice,” says Dr. Boccia, “and that we know will lower the incidence of recurrence by about 40-50%.” For Stage IV diseases, which make up about 20% of the cases that RCCA Maryland sees each year, chemotherapy, targeted therapy and even immunotherapy can be used to offer aggressive treatment. If they no longer respond to a particular drug, patients will be introduced to a new regimen.

In regards to new research and treatment options, Dr. Boccia concludes, “I have 50 to 60 clinical trials open at all times in the center, so we’re always looking actively for good, cutting-edge therapies and offering those to our patients.”

 

If you or someone you love has been diagnosed with colorectal cancer, schedule an appointment at one of RCCA’s 29 locations in New Jersey, Maryland or Connecticut for personalized, professional care.

Molecular Testing: Tailoring Treatment by Targeting Pathways

Phillip D. Reid, MD

 

What is molecular testing? How it is used in cancer care?

A.  As we learn how to treat specific subtypes of cancer more accurately, molecular testing, molecular medicine and molecular diagnostics are becoming more prominent in oncology.

In the past, once a cancer was diagnosed, we determined the organ where it started, how much cancer was in the body and where it was. We have since discovered many pathways through which a cancer develops. We now need to know not only the stage, type and origin of cancer, but also the pathway through which it developed and then target that pathway.

 

How does the pathway concept affect therapy selection?

A.  It enhances our ability to treat the cancer, but we now need extra testing on a patient’s particular cancer cells. The great thing about molecular testing is we get an answer specific for the individual, not just for everyone, for example, with lung cancer. But it does require more time for us to find the pathway. From the patient’s standpoint, diagnosis and stage are obtained, and then sometimes we have to send off the cancer cells for extra testing, which increases the time between diagnosis and treatment. But ultimately, a better sense is provided of what drug to use and when to use it, and there’s a much greater likelihood of devising specific, effective treatment.

 

For which types of cancer should molecular testing be used?

A.  Molecular testing has revolutionized every major cancer diagnosis. Patients with lung and breast cancer are the best candidates, but molecular testing also is useful in colon cancer, head-and-neck and bladder cancer, and some leukemias and myelomas.

 

What have been the main developments over the last two to three years with molecular testing?

A.  It’s becoming easier and more standardized to get molecular testing done. A patient receives a diagnosis and his or her cancer is sent off to a lab, which evaluates all known pathways for that cancer. A specific result is received. As the patient receives therapy, sometimes the cancer changes and he or she may need a second or third biopsy one to three years after the initial diagnosis to see what’s changed in the cancer, and then the treatment changes based on that result. We now see cancer as a moving target as it progresses, and we have to recalibrate every few years so that we’re shooting that target correctly.

 

What should patients know about molecular testing before proceeding?

A.  After a patient receives his or her staging diagnosis, the next question is, “What subtype of lung cancer do I have and what pathway did the cancer use to develop?” The patient needs to have patience, as that extra information may not arrive for two to four weeks, but that information can increase the chances of treatment success.

Also ask about clinical trials of cancer medications before beginning therapy, because we often know about upcoming medications that are effective and possibly better than what we have right now.

Colorectal Cancer Trends and Treatment

Ralph V. Boccia, MD, a cancer specialist at RCCA Maryland, provides some insight into recent colorectal cancer trends and treatments that are giving new hope to doctors, researchers and patients nationwide. Overall, Dr. Boccia finds much to be encouraged by, but also points to the need for awareness of a concerning development in the field of colorectal cancer.

 

How Far We’ve Come and Where We’re Going

As a whole, colorectal cancer rates have been dropping. According to the National Cancer Institute and Centers for Disease Control and Prevention, Maryland alone has seen a 2.6% decrease in the amount of new CRC patients diagnosed over a five-year period. Dr. Boccia believes this trend can be partly attributed to the following:

  • Widespread increase in colonoscopies and other CRC screening methods
  • Early detection and removal of polyps before they become cancerous
  • More cases being diagnosed at an early stage – when the cancer is more responsive to treatment

Despite the good news, it’s still projected that 2,358 Maryland residents will be diagnosed and that 927 people will die from the disease this year, says Dr. Boccia. Doctors have also been noticing an uncharacteristic increase in the amount of younger adults being diagnosed with CRC. Since it typically affects individuals above the age of 50, this emerging demographic has been cause for concern. But Dr. Boccia and his colleagues will continue to conduct research and make further strides in colorectal cancer care to better serve patients of all ages.

 

Current Treatment Options

Surgical innovations, targeted therapies, immunotherapies, chemotherapy and clinical trials are paving the way for more effective CRC solutions. Dr. Boccia explains, “We have a greater ability than ever before to individualize care, and to offer patients multi-modal treatment regimens that employ a variety of mechanisms of action to combat cancer by different means.”

 

Reducing Your Risk

Follow these tips to help reduce your risk for developing colorectal cancer:

  • Maintain a healthy weight
  • Stay physically active
  • Avoid smoking cigarettes and only drink alcohol in moderation
  • Get a CRC screening regularly
  • Consult a physician right away if you experience any CRC symptoms, such as blood in the stool and persistent abdominal pain
  • Manage other conditions that may increase your risk for CRC, like type 2 diabetes, inflammatory bowel disease and adenomatous polyps

 

If you or someone you love has been diagnosed with colorectal cancer, schedule an appointment at one of RCCA’s 29 locations in New Jersey, Maryland or Connecticut for personalized, professional care.

RCCA Earns URAC Accreditation In Specialty Pharmacy

[Hackensack, NJ] – RCCA is proud to announce that it has earned URAC accreditation in Specialty Pharmacy. URAC is the independent leader in promoting healthcare quality through accreditation, certification and measurement. By achieving this status, RCCA has demonstrated a comprehensive commitment to quality care, improved processes and better patient outcomes.

 

“URAC Accreditation is a testament to the commitment of delivering the highest level of quality standards to our patients and their caregivers,” said Terrill Jordan, President and CEO of RCCA. ”This type of commitment is the cornerstone of everything we do at RCCA,” he added.

Edward Licitra, MD, PhD, RCCA Chairperson of the Board and RCCA Pharmacy Medical Director and Eileen Peng, PharmD, Director of the RCCA Pharmacy agree that “this new recognition will allow us to continue to provide the highest level of patient care and convenience for the people that need it the most.”

 

“Pharmacy services have never played such an important role in the delivery of care as they do today. RCCA distinguishes itself for having voluntarily undergone a rigorous review of quality standards that earned it URAC accreditation,” said URAC President and CEO Kylanne Green. “Independent URAC accreditation shows RCCA is dedicated to quality and safety, and that it strives for a continual improvement of its services.”

ABOUT RCCA

Regional Cancer Care Associates (RCCA), one of the largest oncology physician networks in the United States, is transforming oncology care by ensuring that cancer patients have access to the highest-quality, most-comprehensive, cutting edge treatments in a compassionate and community-based setting. RCCA includes more than 100 cancer care specialists and is supported by 800 employees at more than 30 care delivery sites, providing care to more than 24,000 new patients annually and over 240,000 existing patients.  For more information visit: http://www.RCCA.com

About URAC

Founded in 1990, URAC is the independent leader in promoting healthcare quality through accreditation, certification and measurement. URAC is a nonprofit organization developing evidence-based measures and standards through inclusive engagement with a range of stakeholders committed to improving the quality of healthcare. Our portfolio of accreditation and certification programs span the healthcare industry, addressing healthcare management, healthcare operations, health plans, pharmacies, telehealth providers, physician practices, and more. URAC accreditation is a symbol of excellence for organizations to showcase their validated commitment to quality and accountability.

For further information, contact:

Mary Lou Salvemini
msalvemini@regionalcancercare.org
(201) 510-0922

RCCA Makes Innovative UnitedHealthcare Cancer Care Program Available to Patients in Maryland

HACKENSACK, N.J., Nov. 22, 2016 /PRNewswire-USNewswire/ — Regional Cancer Care Associates (RCCA) is expanding its cancer care payment initiative with UnitedHealthcare to RCCA patients in Maryland who are covered by UnitedHealthcare benefit plans.

The program, made available at RCCA New Jersey locations in January, rewards physicians for focusing on best treatment practices, quality patient care and better health outcomes. The program pays participating medical oncologists more if they demonstrate superior clinical results and if they reduce the total cost of care.

The episode payment model shifts reimbursement away from the current “fee-for-service” approach that emphasizes volume of care delivered regardless of a patient’s health outcomes. The episode payment is based on the expected cost of a standard treatment regimen for a specific condition, as predetermined by the doctor. Similar payment models have been shown to enhance care coordination and improve health outcomes for patients, while reducing overall costs.

“RCCA has emerged as a leader in delivering the highest-level quality cancer care to our patients,” said Terrill Jordan, RCCA President and CEO. “New payment methodologies like this put patients’ interests at the forefront of cancer treatment. It also results in significant cost savings, which advances efforts across the country to assist in controlling rising health care costs. We are excited to offer this program to our Maryland patient base.”

Lee N. Newcomer, M.D., UnitedHealthcare’s Senior Vice President, Oncology, said: “Our partnership with RCCA marks an important step toward expanded episode payment models and away from the traditional fee-for-service payments for oncology care. We look forward to working with RCCA and others to expand our efforts to identify best practices for treating cancer.”

A study published in the Journal of Oncology Practice has demonstrated that this program reduced overall cancer expenses by more than a third while improving quality outcomes. RCCA is among five oncology practices that have joined the program, which now has a total of more than 650 oncologists. RCCA in New Jersey and now Maryland comprise approximately 100 of these oncologists.

“Value-based cancer care is here. This program will enable Maryland-based RCCA oncologists to continue to provide patient-centered care at the highest level of quality,” said Ralph Boccia, M.D., RCCA Research Deputy Chair and Oncologist in Bethesda and Germantown, Md.

UnitedHealthcare first implemented its episode payment program as a pilot study between October 2009 and December 2012. The pilot study produced a significant reduction in hospitalizations and a 34 percent reduction in total costs while improving quality. Click here to read results of the study.

About RCCA
Regional Cancer Care Associates (RCCA), one of the largest oncology physician networks in the United States, is transforming oncology care by ensuring that cancer patients have access to the highest-quality, most-comprehensive, cutting edge treatments in a compassionate and community-based setting. RCCA includes 100 cancer care specialists and is supported by 700 employees at 27 care delivery sites, providing care to more than 230,000 existing patients in New Jersey, Maryland and Washington DC.  For more information visit: http://www.RCCA.com

Contact:

Mary Lou Salvemini
msalvemini@regionalcancercare.org
(201) 510-0922

REGIONAL CANCER CARE ASSOCIATES AND AETNA FORM ONCOLOGY MEDICAL HOME

REGIONAL CANCER CARE ASSOCIATES AND AETNA FORM ONCOLOGY MEDICAL HOME

— The Patient-Focused Model Supports High-Value Care–

 

Hackensack, NJ, October 12, 2016 — Regional Cancer Care Associates (RCCA) and Aetna (NYSE: AET) announced a collaboration to create an oncology medical home that is designed to improve the care experience for cancer patients.

In the oncology medical home model, teams of cancer specialists collectively provide a patient’s health care when he or she has a cancer diagnosis. The model will give RCCA the responsibility to arrange appropriate care that is continuous and proactive and physicians will be incentivized for improved health, affordability and a better patient experience.

The oncology medical home arrangement will be available to patients at all RCCA locations in New Jersey and Maryland.

“RCCA is excited to partner with Aetna on this program. It aligns with our vision of providing patient centered care close to home,” said Terrill Jordan, RCCA President & CEO. “This partnership will not only enable us to continue the delivery of high quality care through reduced side effects, but will also facilitate cost effective care based on the data Aetna will be sharing,” said Michael Ruiz de Somocurcio, RCCA Vice President of Payer and Provider Collaboration.

The model is part of a strategic direction to transition from fee-for-service medicine to value-based payment. Value-based arrangements are emerging as a solution to address rising health care costs, clinical inefficiency, duplication of services, and access to care. In value-based models, doctors and hospitals are paid for helping to keep people healthy and for improving the health of those who have chronic conditions in an evidence-based, cost-effective way.

“We understand that cancer treatment can be the hardest experience that our members will ever have to go through,” said Daniel Knecht, M.D., M.B.A., Aetna’s Head of Strategy & Planning and Interim Head of Oncology Solutions. “This oncology medical home with RCCA will help provide our members with high-quality care and an optimal patient experience.”

The operating principles of the RCCA and Aetna oncology medical home include:

  • An orientation to the whole person. A personal physician from RCCA will be responsible for providing or arranging all of a patient’s health care needs with other qualified professionals. This includes care for all stages of treatment: preventive services, acute care, chronic care, palliative care and end-of-life care.
  • Evidence-based, personalized medical care. The RCCA team will focus on making treatment decisions based on current medical evidence for each unique disease presentation, patient-specific factors and patient choice using appropriate treatments to improve quality and outcomes.
  • Coordinated and integrated care. Care will be facilitated, across all elements of the health system, to enable Aetna members to get the appropriate care when and where it is needed and wanted, in a culturally and linguistically appropriate manner.
  • Quality and safety. Quality and safety will be a focus of care, including the use of evidence-based medicine, clinical decision support tools and accountability for continuous quality improvement.
  • Enhanced access to care. Care will be available through systems such as open scheduling, expanded hours and new options for communication between Aetna members, their personal physicians and hospital staff.

The oncology medical home arrangement launched in September 2016.

About RCCA

Regional Cancer Care Associates (RCCA), one of the largest oncology physician networks in the United States, is transforming oncology care by ensuring that cancer patients have access to the highest-quality, most-comprehensive, cutting edge treatments in a compassionate and community-based setting. RCCA includes 100 cancer care specialists and is supported by 700 employees at 27 care delivery sites, providing care to more than 23,000 new patients annually and over 230,000 existing patients in New Jersey, Maryland and Washington DC. For more information visit: http://www.RCCA.com.

About Aetna

Aetna is one of the nation’s leading diversified health care benefits companies, serving an estimated 46.3 million people with information and resources to help them make better informed decisions about their health care. Aetna offers a broad range of traditional, voluntary and consumer-directed health insurance products and related services, including medical, pharmacy, dental, behavioral health, group life and disability plans, and medical management capabilities, Medicaid health care management services, workers’ compensation administrative services and health information technology products and services. Aetna’s customers include employer groups, individuals, college students, part-time and hourly workers, health plans, health care providers, governmental units, government-sponsored plans, labor groups and expatriates. For more information, see www.aetna.com and learn about how Aetna is helping to build a healthier world. @AetnaNews

 

###

What Cancer Patients Need To Know About Clinical Trials: Insights From New Jersey Hematologist /Oncologist Seth Berk

Seth Howard Berk, MD, a hematologist and medical oncologist with RCCA, reveals four facts that he shares with his patients when they ask about clinical trials.

First, a drug has been thoroughly tested well before it reaches the clinical trial stage. Pre-clinical trial testing involves looking at a drug’s effects on animals as well as human cells. This stage usually takes years of development. Also, the clinical studies have to be designed and conducted in accordance with rigorous ethical and safety criteria.

He also imparts the importance of not thinking of clinical trials as a last resort in treatment. While trials are typically suited for situations in which traditional therapy methods are not working for a patient, there is more evidence emerging of late-stage trials benefitting the patient when used early in the diagnosis process.

A myth that Dr. Berk debunks is the use of a placebo in cancer treatment. Some cancer patients are resistant to clinical trials because they fear there will be a placebo and they will suffer as a result. He says this is misinformation or something assumed from a patient’s memory of high school or college science experiments. In clinical trials, one group will be administered the trial agent while the other continues to have traditional therapy. There are rarely ever patients receiving zero care.

Lastly, Dr. Berk addresses the importance of clinical trials for cancer patients in general. Because of willing patients participating in more and more trials, doctors and patients can share in a community of knowledge and understanding, and, one day, a cure.

To read more about clinical trials, turn to “What cancer patients need to know about clinical trials: Insights from New Jersey oncologist/hematologist Seth Berk.”

RCCA: Taking Cancer Care To A Higher Level In NJ And Beyond

Edward J. Licitra, MD, PhD, board certified in internal medicine, hematology and medical oncology and chairman of the board of directors of Regional Cancer Care Associates (RCCA), shares some of his thoughts on potential models for a health care delivery reform system. Oncologists at RCCA, totaling 100 physicians, learn from each other’s best practices with the patient’s interest at the forefront. Through RCCA, patients can receive care at home instead of visiting a hospital or clinic. They have set up 27 care delivery sites, providing care to more than 23,000 new patients annually and approximately 230,000 existing patients in New Jersey, Maryland and Washington, D.C.

Another example of a successful care reform case is the Oncology Care Model (OCM) created by Medicare under the Affordable Care Act (ACA). The model questions how to best develop an integrated style of cancer care. It focuses on developing a care model for the future, using data sharing and streamlining economics for patients as well as providers. By digitizing patients’ medical histories and sharing them through hospitals and clinics, this model focuses on simplifying the oncology care process.

Lastly, the OCM utilizes evidence-based-medicine (EBM) practices throughout the entire spectrum of care. EBM produces the best methods regardless of cost, while even reducing cost by eliminating wasteful spending. The OCM focuses on patient-focused, research based therapy tailored to the individual patient.

To learn more about this topic, read “RCCA: Taking cancer care to a higher level in NJ and beyond.”

Targeting Treatments for Chronic Lymphocytic Leukemia

Dr. Joel Silver

 

How do myeloma and chronic lymphocytic leukemia (CLL) develop? What are some risk factors associated with those malignancies?

A. We don’t know what causes CLL. We do know that people in some occupations or with a certain exposure history might be at higher risk, and that CLL generally affects older people. Treatment fortunately is not needed in many cases, but even so our treatment options have evolved based on cytogenetics and next-generation sequencing. We have more ways to assess prognostic features and design more personalized and potentially more effective therapy for people with CLL.

 

What therapies have been successful in treating CLL over the last two to three years?

A. If you can identify a certain kind of CLL, such as IDH-mutated CLL, some of the patients with it can receive a standard chemotherapy regimen called FCR, and they sometimes go into remission indefinitely. It depends on whether the patient is young and healthy enough to tolerate the therapy. That’s a select group, though; you don’t see too many young people with CLL.

Years ago, an effective treatment did not exist for another group of patients with CLL, those with the genetic 17p deletion. In recent years, however, the oral agent ibrutinib has shown effectiveness for CLL in this group. Other therapies now are available for patients who don’t respond to ibrutinib.

 

Where does targeted therapy come into play?

A. In general, “targeted therapy” refers to a treatment based on a particular mutation or pattern. The presence of the genetic 17p deletion in CLL is one example, but this is a bad cytogenetic abnormality for which standard treatments such as chemotherapy haven’t worked. If we can identify a particular mutation, then we can target our therapy and plan treatment that we know will work, instead of going through chemotherapies that are only partially effective or downright ineffective and then finding that the patient is resistant to treatment.

 

Are there side effects or drawbacks to targeted therapy?

A. Everything we do has side effects. The oral agent ibrutinib has been an effective first-line therapy for any type of CLL. Although the agent is specifically for patients with 17p deletion, it has also worked for patients without that genetic feature. While some cardiovascular and bleeding issues have been reported, ibrutinib overall is more tolerable than chemotherapy.

When we medically examine patients with CLL, we always look at a pattern of mutations to try to identify how to treat these people — not so much from an immediate therapeutic standpoint, but to gain knowledge of all these other cytogenetic abnormalities so that eventually, we will find other ways to target those different patterns.

What important points do you address with patients before they begin CLL therapy?

A. Many people with CLL don’t die of their disease, they die with their disease, so I tell patients not to be afraid of the disease itself. Many of the conversations we have with these people, however, revolve around the fact that they have this problem but may never need treatment. “We should follow you because you may need treatment down the line,” I tell them. “If you need treatment, we have many effective therapies.”

 

Do you foresee different therapies for CLL emerging within the next two to three years?

A. A number of medications are on the horizon that will be appropriate for any patient with CLL. For example, venetoclax, which gained FDA approval last year, is indicated for second-line treatment of CLL in patients with the 17p deletion, but I think that agent will be effective for all patients with CLL. As similarly versatile agents are developed, we will have many more treatment options.

Colorectal Cancer Trends in Maryland: A Conversation with Dr. Ralph V. Boccia

As the third most common cancer in the United States, colorectal cancer (CRC) affects about 1 in 20 Americans. However, incidence and death rates for cancer of the colorectum have significantly decreased over the past several decades as a result of increased screening and drastic improvements in treatment. In Maryland alone, approximately 70% of adults over the age of 50 have an up-to-date colorectal cancer screening, helping contribute to the reduction in mortality rates.

Dr. Ralph V. Boccia, an oncology and hematology specialist at Regional Cancer Care Associates (RCCA) in Bethesda and Germantown, Maryland says, “The more colorectal screening we have and the earlier it gets started, the lower the stage that the cancer is typically picked up.” In turn, early detection has led to the state’s lower mortality rates over time.

 

The Benefits Of Increased Screening

According to Dr. Boccia, improving screening rates “affects the stage at which the cancer presents itself and [the patient’s] potential for survival.” Between 2002 and 2010, the percentage of Maryland adults with up-to-date colorectal cancer screenings increased from 64% to 71%. As a result, CRC mortality rates in Maryland decreased considerably among both men and women in that eight-year timeframe. Dr. Boccia explains, “The trend we’ve actually seen – which is that more people are being screened – has resulted in more improvements of overall survival in patients with colorectal cancer.”

However, as colon cancer rates decline in adults 50 years and older, both incidence and death rates are increasing in the under-50 population. “We’re seeing a scary trend of younger patients getting colorectal cancer,” remarks Dr. Boccia, “even down into the 20s.” However, at this point in time, there’s insufficient data to clearly identify the causation behind this trend.

 

Colorectal Cancer Risk Factors

According to a report from the Maryland Department of Health and Mental Hygiene, the incidence rate of colon cancer per 100,000 people in Maryland was 1,174 for men and 1,109 for women in 2012. When looking at new cases of CRC, research shows that incidence may be tied to habits and lifestyles. Among these lifestyle- associated risk factors are being overweight or obese, lack of physical activity, smoking, heavy alcohol use and certain types of diets.

As outlined by the American Cancer Society, other risk factors unrelated to lifestyle choices are personal and family histories of colorectal cancer or adenomatous polyps, having type 2 diabetes, possessing an inherited syndrome, such as Lynch Syndrome, and certain racial and ethnic backgrounds. In addition, Dr. Boccia notes that a personal history of inflammatory bowel disease may increase the risk for developing colorectal cancer. “Patients with ulcerative colitis have to be screened very frequently for colon cancer,” Dr. Boccia elucidates, “because of that high predisposition.”

 

Common CRC Treatments

“For early stage colorectal cancer, the treatment of choice is surgery,” says Dr. Boccia. In this stage, a group of abnormal cells, referred to as carcinoma in situ (CIS), can be removed by a polypectomy, or a part of the colon can be removed via a partial colectomy. Once the cancer has penetrated the wall of the colon and perhaps even grown into nearby tissue, patients of RCCA Maryland will typically undergo active surveillance – although other treatment options are offered to those with high-risk tumors, says Dr. Boccia.

Once the cancer has reached Stage III, patients are generally offered a form of chemotherapy for roughly six weeks. “FOLFOX is the adjuvant therapy of choice,” says Dr. Boccia, “and that we know will lower the incidence of recurrence by about 40-50%.” For Stage IV diseases, which make up about 20% of the cases that RCCA Maryland sees each year, chemotherapy, targeted therapy and even immunotherapy can be used to offer aggressive treatment. If they no longer respond to a particular drug, patients will be introduced to a new regimen.

In regards to new research and treatment options, Dr. Boccia concludes, “I have 50 to 60 clinical trials open at all times in the center, so we’re always looking actively for good, cutting-edge therapies and offering those to our patients.”

 

If you or someone you love has been diagnosed with colorectal cancer, schedule an appointment at one of RCCA’s 29 locations in New Jersey, Maryland or Connecticut for personalized, professional care.

Molecular Testing: Tailoring Treatment by Targeting Pathways

Phillip D. Reid, MD

 

What is molecular testing? How it is used in cancer care?

A.  As we learn how to treat specific subtypes of cancer more accurately, molecular testing, molecular medicine and molecular diagnostics are becoming more prominent in oncology.

In the past, once a cancer was diagnosed, we determined the organ where it started, how much cancer was in the body and where it was. We have since discovered many pathways through which a cancer develops. We now need to know not only the stage, type and origin of cancer, but also the pathway through which it developed and then target that pathway.

 

How does the pathway concept affect therapy selection?

A.  It enhances our ability to treat the cancer, but we now need extra testing on a patient’s particular cancer cells. The great thing about molecular testing is we get an answer specific for the individual, not just for everyone, for example, with lung cancer. But it does require more time for us to find the pathway. From the patient’s standpoint, diagnosis and stage are obtained, and then sometimes we have to send off the cancer cells for extra testing, which increases the time between diagnosis and treatment. But ultimately, a better sense is provided of what drug to use and when to use it, and there’s a much greater likelihood of devising specific, effective treatment.

 

For which types of cancer should molecular testing be used?

A.  Molecular testing has revolutionized every major cancer diagnosis. Patients with lung and breast cancer are the best candidates, but molecular testing also is useful in colon cancer, head-and-neck and bladder cancer, and some leukemias and myelomas.

 

What have been the main developments over the last two to three years with molecular testing?

A.  It’s becoming easier and more standardized to get molecular testing done. A patient receives a diagnosis and his or her cancer is sent off to a lab, which evaluates all known pathways for that cancer. A specific result is received. As the patient receives therapy, sometimes the cancer changes and he or she may need a second or third biopsy one to three years after the initial diagnosis to see what’s changed in the cancer, and then the treatment changes based on that result. We now see cancer as a moving target as it progresses, and we have to recalibrate every few years so that we’re shooting that target correctly.

 

What should patients know about molecular testing before proceeding?

A.  After a patient receives his or her staging diagnosis, the next question is, “What subtype of lung cancer do I have and what pathway did the cancer use to develop?” The patient needs to have patience, as that extra information may not arrive for two to four weeks, but that information can increase the chances of treatment success.

Also ask about clinical trials of cancer medications before beginning therapy, because we often know about upcoming medications that are effective and possibly better than what we have right now.

Colorectal Cancer Trends and Treatment

Ralph V. Boccia, MD, a cancer specialist at RCCA Maryland, provides some insight into recent colorectal cancer trends and treatments that are giving new hope to doctors, researchers and patients nationwide. Overall, Dr. Boccia finds much to be encouraged by, but also points to the need for awareness of a concerning development in the field of colorectal cancer.

 

How Far We’ve Come and Where We’re Going

As a whole, colorectal cancer rates have been dropping. According to the National Cancer Institute and Centers for Disease Control and Prevention, Maryland alone has seen a 2.6% decrease in the amount of new CRC patients diagnosed over a five-year period. Dr. Boccia believes this trend can be partly attributed to the following:

  • Widespread increase in colonoscopies and other CRC screening methods
  • Early detection and removal of polyps before they become cancerous
  • More cases being diagnosed at an early stage – when the cancer is more responsive to treatment

Despite the good news, it’s still projected that 2,358 Maryland residents will be diagnosed and that 927 people will die from the disease this year, says Dr. Boccia. Doctors have also been noticing an uncharacteristic increase in the amount of younger adults being diagnosed with CRC. Since it typically affects individuals above the age of 50, this emerging demographic has been cause for concern. But Dr. Boccia and his colleagues will continue to conduct research and make further strides in colorectal cancer care to better serve patients of all ages.

 

Current Treatment Options

Surgical innovations, targeted therapies, immunotherapies, chemotherapy and clinical trials are paving the way for more effective CRC solutions. Dr. Boccia explains, “We have a greater ability than ever before to individualize care, and to offer patients multi-modal treatment regimens that employ a variety of mechanisms of action to combat cancer by different means.”

 

Reducing Your Risk

Follow these tips to help reduce your risk for developing colorectal cancer:

  • Maintain a healthy weight
  • Stay physically active
  • Avoid smoking cigarettes and only drink alcohol in moderation
  • Get a CRC screening regularly
  • Consult a physician right away if you experience any CRC symptoms, such as blood in the stool and persistent abdominal pain
  • Manage other conditions that may increase your risk for CRC, like type 2 diabetes, inflammatory bowel disease and adenomatous polyps

 

If you or someone you love has been diagnosed with colorectal cancer, schedule an appointment at one of RCCA’s 29 locations in New Jersey, Maryland or Connecticut for personalized, professional care.

RCCA Earns URAC Accreditation In Specialty Pharmacy

[Hackensack, NJ] – RCCA is proud to announce that it has earned URAC accreditation in Specialty Pharmacy. URAC is the independent leader in promoting healthcare quality through accreditation, certification and measurement. By achieving this status, RCCA has demonstrated a comprehensive commitment to quality care, improved processes and better patient outcomes.

 

“URAC Accreditation is a testament to the commitment of delivering the highest level of quality standards to our patients and their caregivers,” said Terrill Jordan, President and CEO of RCCA. ”This type of commitment is the cornerstone of everything we do at RCCA,” he added.

Edward Licitra, MD, PhD, RCCA Chairperson of the Board and RCCA Pharmacy Medical Director and Eileen Peng, PharmD, Director of the RCCA Pharmacy agree that “this new recognition will allow us to continue to provide the highest level of patient care and convenience for the people that need it the most.”

 

“Pharmacy services have never played such an important role in the delivery of care as they do today. RCCA distinguishes itself for having voluntarily undergone a rigorous review of quality standards that earned it URAC accreditation,” said URAC President and CEO Kylanne Green. “Independent URAC accreditation shows RCCA is dedicated to quality and safety, and that it strives for a continual improvement of its services.”

ABOUT RCCA

Regional Cancer Care Associates (RCCA), one of the largest oncology physician networks in the United States, is transforming oncology care by ensuring that cancer patients have access to the highest-quality, most-comprehensive, cutting edge treatments in a compassionate and community-based setting. RCCA includes more than 100 cancer care specialists and is supported by 800 employees at more than 30 care delivery sites, providing care to more than 24,000 new patients annually and over 240,000 existing patients.  For more information visit: http://www.RCCA.com

About URAC

Founded in 1990, URAC is the independent leader in promoting healthcare quality through accreditation, certification and measurement. URAC is a nonprofit organization developing evidence-based measures and standards through inclusive engagement with a range of stakeholders committed to improving the quality of healthcare. Our portfolio of accreditation and certification programs span the healthcare industry, addressing healthcare management, healthcare operations, health plans, pharmacies, telehealth providers, physician practices, and more. URAC accreditation is a symbol of excellence for organizations to showcase their validated commitment to quality and accountability.

For further information, contact:

Mary Lou Salvemini
msalvemini@regionalcancercare.org
(201) 510-0922

RCCA Makes Innovative UnitedHealthcare Cancer Care Program Available to Patients in Maryland

HACKENSACK, N.J., Nov. 22, 2016 /PRNewswire-USNewswire/ — Regional Cancer Care Associates (RCCA) is expanding its cancer care payment initiative with UnitedHealthcare to RCCA patients in Maryland who are covered by UnitedHealthcare benefit plans.

The program, made available at RCCA New Jersey locations in January, rewards physicians for focusing on best treatment practices, quality patient care and better health outcomes. The program pays participating medical oncologists more if they demonstrate superior clinical results and if they reduce the total cost of care.

The episode payment model shifts reimbursement away from the current “fee-for-service” approach that emphasizes volume of care delivered regardless of a patient’s health outcomes. The episode payment is based on the expected cost of a standard treatment regimen for a specific condition, as predetermined by the doctor. Similar payment models have been shown to enhance care coordination and improve health outcomes for patients, while reducing overall costs.

“RCCA has emerged as a leader in delivering the highest-level quality cancer care to our patients,” said Terrill Jordan, RCCA President and CEO. “New payment methodologies like this put patients’ interests at the forefront of cancer treatment. It also results in significant cost savings, which advances efforts across the country to assist in controlling rising health care costs. We are excited to offer this program to our Maryland patient base.”

Lee N. Newcomer, M.D., UnitedHealthcare’s Senior Vice President, Oncology, said: “Our partnership with RCCA marks an important step toward expanded episode payment models and away from the traditional fee-for-service payments for oncology care. We look forward to working with RCCA and others to expand our efforts to identify best practices for treating cancer.”

A study published in the Journal of Oncology Practice has demonstrated that this program reduced overall cancer expenses by more than a third while improving quality outcomes. RCCA is among five oncology practices that have joined the program, which now has a total of more than 650 oncologists. RCCA in New Jersey and now Maryland comprise approximately 100 of these oncologists.

“Value-based cancer care is here. This program will enable Maryland-based RCCA oncologists to continue to provide patient-centered care at the highest level of quality,” said Ralph Boccia, M.D., RCCA Research Deputy Chair and Oncologist in Bethesda and Germantown, Md.

UnitedHealthcare first implemented its episode payment program as a pilot study between October 2009 and December 2012. The pilot study produced a significant reduction in hospitalizations and a 34 percent reduction in total costs while improving quality. Click here to read results of the study.

About RCCA
Regional Cancer Care Associates (RCCA), one of the largest oncology physician networks in the United States, is transforming oncology care by ensuring that cancer patients have access to the highest-quality, most-comprehensive, cutting edge treatments in a compassionate and community-based setting. RCCA includes 100 cancer care specialists and is supported by 700 employees at 27 care delivery sites, providing care to more than 230,000 existing patients in New Jersey, Maryland and Washington DC.  For more information visit: http://www.RCCA.com

Contact:

Mary Lou Salvemini
msalvemini@regionalcancercare.org
(201) 510-0922

REGIONAL CANCER CARE ASSOCIATES AND AETNA FORM ONCOLOGY MEDICAL HOME

REGIONAL CANCER CARE ASSOCIATES AND AETNA FORM ONCOLOGY MEDICAL HOME

— The Patient-Focused Model Supports High-Value Care–

 

Hackensack, NJ, October 12, 2016 — Regional Cancer Care Associates (RCCA) and Aetna (NYSE: AET) announced a collaboration to create an oncology medical home that is designed to improve the care experience for cancer patients.

In the oncology medical home model, teams of cancer specialists collectively provide a patient’s health care when he or she has a cancer diagnosis. The model will give RCCA the responsibility to arrange appropriate care that is continuous and proactive and physicians will be incentivized for improved health, affordability and a better patient experience.

The oncology medical home arrangement will be available to patients at all RCCA locations in New Jersey and Maryland.

“RCCA is excited to partner with Aetna on this program. It aligns with our vision of providing patient centered care close to home,” said Terrill Jordan, RCCA President & CEO. “This partnership will not only enable us to continue the delivery of high quality care through reduced side effects, but will also facilitate cost effective care based on the data Aetna will be sharing,” said Michael Ruiz de Somocurcio, RCCA Vice President of Payer and Provider Collaboration.

The model is part of a strategic direction to transition from fee-for-service medicine to value-based payment. Value-based arrangements are emerging as a solution to address rising health care costs, clinical inefficiency, duplication of services, and access to care. In value-based models, doctors and hospitals are paid for helping to keep people healthy and for improving the health of those who have chronic conditions in an evidence-based, cost-effective way.

“We understand that cancer treatment can be the hardest experience that our members will ever have to go through,” said Daniel Knecht, M.D., M.B.A., Aetna’s Head of Strategy & Planning and Interim Head of Oncology Solutions. “This oncology medical home with RCCA will help provide our members with high-quality care and an optimal patient experience.”

The operating principles of the RCCA and Aetna oncology medical home include:

  • An orientation to the whole person. A personal physician from RCCA will be responsible for providing or arranging all of a patient’s health care needs with other qualified professionals. This includes care for all stages of treatment: preventive services, acute care, chronic care, palliative care and end-of-life care.
  • Evidence-based, personalized medical care. The RCCA team will focus on making treatment decisions based on current medical evidence for each unique disease presentation, patient-specific factors and patient choice using appropriate treatments to improve quality and outcomes.
  • Coordinated and integrated care. Care will be facilitated, across all elements of the health system, to enable Aetna members to get the appropriate care when and where it is needed and wanted, in a culturally and linguistically appropriate manner.
  • Quality and safety. Quality and safety will be a focus of care, including the use of evidence-based medicine, clinical decision support tools and accountability for continuous quality improvement.
  • Enhanced access to care. Care will be available through systems such as open scheduling, expanded hours and new options for communication between Aetna members, their personal physicians and hospital staff.

The oncology medical home arrangement launched in September 2016.

About RCCA

Regional Cancer Care Associates (RCCA), one of the largest oncology physician networks in the United States, is transforming oncology care by ensuring that cancer patients have access to the highest-quality, most-comprehensive, cutting edge treatments in a compassionate and community-based setting. RCCA includes 100 cancer care specialists and is supported by 700 employees at 27 care delivery sites, providing care to more than 23,000 new patients annually and over 230,000 existing patients in New Jersey, Maryland and Washington DC. For more information visit: http://www.RCCA.com.

About Aetna

Aetna is one of the nation’s leading diversified health care benefits companies, serving an estimated 46.3 million people with information and resources to help them make better informed decisions about their health care. Aetna offers a broad range of traditional, voluntary and consumer-directed health insurance products and related services, including medical, pharmacy, dental, behavioral health, group life and disability plans, and medical management capabilities, Medicaid health care management services, workers’ compensation administrative services and health information technology products and services. Aetna’s customers include employer groups, individuals, college students, part-time and hourly workers, health plans, health care providers, governmental units, government-sponsored plans, labor groups and expatriates. For more information, see www.aetna.com and learn about how Aetna is helping to build a healthier world. @AetnaNews

 

###

What Cancer Patients Need To Know About Clinical Trials: Insights From New Jersey Hematologist /Oncologist Seth Berk

Seth Howard Berk, MD, a hematologist and medical oncologist with RCCA, reveals four facts that he shares with his patients when they ask about clinical trials.

First, a drug has been thoroughly tested well before it reaches the clinical trial stage. Pre-clinical trial testing involves looking at a drug’s effects on animals as well as human cells. This stage usually takes years of development. Also, the clinical studies have to be designed and conducted in accordance with rigorous ethical and safety criteria.

He also imparts the importance of not thinking of clinical trials as a last resort in treatment. While trials are typically suited for situations in which traditional therapy methods are not working for a patient, there is more evidence emerging of late-stage trials benefitting the patient when used early in the diagnosis process.

A myth that Dr. Berk debunks is the use of a placebo in cancer treatment. Some cancer patients are resistant to clinical trials because they fear there will be a placebo and they will suffer as a result. He says this is misinformation or something assumed from a patient’s memory of high school or college science experiments. In clinical trials, one group will be administered the trial agent while the other continues to have traditional therapy. There are rarely ever patients receiving zero care.

Lastly, Dr. Berk addresses the importance of clinical trials for cancer patients in general. Because of willing patients participating in more and more trials, doctors and patients can share in a community of knowledge and understanding, and, one day, a cure.

To read more about clinical trials, turn to “What cancer patients need to know about clinical trials: Insights from New Jersey oncologist/hematologist Seth Berk.”

RCCA: Taking Cancer Care To A Higher Level In NJ And Beyond

Edward J. Licitra, MD, PhD, board certified in internal medicine, hematology and medical oncology and chairman of the board of directors of Regional Cancer Care Associates (RCCA), shares some of his thoughts on potential models for a health care delivery reform system. Oncologists at RCCA, totaling 100 physicians, learn from each other’s best practices with the patient’s interest at the forefront. Through RCCA, patients can receive care at home instead of visiting a hospital or clinic. They have set up 27 care delivery sites, providing care to more than 23,000 new patients annually and approximately 230,000 existing patients in New Jersey, Maryland and Washington, D.C.

Another example of a successful care reform case is the Oncology Care Model (OCM) created by Medicare under the Affordable Care Act (ACA). The model questions how to best develop an integrated style of cancer care. It focuses on developing a care model for the future, using data sharing and streamlining economics for patients as well as providers. By digitizing patients’ medical histories and sharing them through hospitals and clinics, this model focuses on simplifying the oncology care process.

Lastly, the OCM utilizes evidence-based-medicine (EBM) practices throughout the entire spectrum of care. EBM produces the best methods regardless of cost, while even reducing cost by eliminating wasteful spending. The OCM focuses on patient-focused, research based therapy tailored to the individual patient.

To learn more about this topic, read “RCCA: Taking cancer care to a higher level in NJ and beyond.”

Targeting Treatments for Chronic Lymphocytic Leukemia

Dr. Joel Silver

 

How do myeloma and chronic lymphocytic leukemia (CLL) develop? What are some risk factors associated with those malignancies?

A. We don’t know what causes CLL. We do know that people in some occupations or with a certain exposure history might be at higher risk, and that CLL generally affects older people. Treatment fortunately is not needed in many cases, but even so our treatment options have evolved based on cytogenetics and next-generation sequencing. We have more ways to assess prognostic features and design more personalized and potentially more effective therapy for people with CLL.

 

What therapies have been successful in treating CLL over the last two to three years?

A. If you can identify a certain kind of CLL, such as IDH-mutated CLL, some of the patients with it can receive a standard chemotherapy regimen called FCR, and they sometimes go into remission indefinitely. It depends on whether the patient is young and healthy enough to tolerate the therapy. That’s a select group, though; you don’t see too many young people with CLL.

Years ago, an effective treatment did not exist for another group of patients with CLL, those with the genetic 17p deletion. In recent years, however, the oral agent ibrutinib has shown effectiveness for CLL in this group. Other therapies now are available for patients who don’t respond to ibrutinib.

 

Where does targeted therapy come into play?

A. In general, “targeted therapy” refers to a treatment based on a particular mutation or pattern. The presence of the genetic 17p deletion in CLL is one example, but this is a bad cytogenetic abnormality for which standard treatments such as chemotherapy haven’t worked. If we can identify a particular mutation, then we can target our therapy and plan treatment that we know will work, instead of going through chemotherapies that are only partially effective or downright ineffective and then finding that the patient is resistant to treatment.

 

Are there side effects or drawbacks to targeted therapy?

A. Everything we do has side effects. The oral agent ibrutinib has been an effective first-line therapy for any type of CLL. Although the agent is specifically for patients with 17p deletion, it has also worked for patients without that genetic feature. While some cardiovascular and bleeding issues have been reported, ibrutinib overall is more tolerable than chemotherapy.

When we medically examine patients with CLL, we always look at a pattern of mutations to try to identify how to treat these people — not so much from an immediate therapeutic standpoint, but to gain knowledge of all these other cytogenetic abnormalities so that eventually, we will find other ways to target those different patterns.

What important points do you address with patients before they begin CLL therapy?

A. Many people with CLL don’t die of their disease, they die with their disease, so I tell patients not to be afraid of the disease itself. Many of the conversations we have with these people, however, revolve around the fact that they have this problem but may never need treatment. “We should follow you because you may need treatment down the line,” I tell them. “If you need treatment, we have many effective therapies.”

 

Do you foresee different therapies for CLL emerging within the next two to three years?

A. A number of medications are on the horizon that will be appropriate for any patient with CLL. For example, venetoclax, which gained FDA approval last year, is indicated for second-line treatment of CLL in patients with the 17p deletion, but I think that agent will be effective for all patients with CLL. As similarly versatile agents are developed, we will have many more treatment options.

Colorectal Cancer Trends in Maryland: A Conversation with Dr. Ralph V. Boccia

As the third most common cancer in the United States, colorectal cancer (CRC) affects about 1 in 20 Americans. However, incidence and death rates for cancer of the colorectum have significantly decreased over the past several decades as a result of increased screening and drastic improvements in treatment. In Maryland alone, approximately 70% of adults over the age of 50 have an up-to-date colorectal cancer screening, helping contribute to the reduction in mortality rates.

Dr. Ralph V. Boccia, an oncology and hematology specialist at Regional Cancer Care Associates (RCCA) in Bethesda and Germantown, Maryland says, “The more colorectal screening we have and the earlier it gets started, the lower the stage that the cancer is typically picked up.” In turn, early detection has led to the state’s lower mortality rates over time.

 

The Benefits Of Increased Screening

According to Dr. Boccia, improving screening rates “affects the stage at which the cancer presents itself and [the patient’s] potential for survival.” Between 2002 and 2010, the percentage of Maryland adults with up-to-date colorectal cancer screenings increased from 64% to 71%. As a result, CRC mortality rates in Maryland decreased considerably among both men and women in that eight-year timeframe. Dr. Boccia explains, “The trend we’ve actually seen – which is that more people are being screened – has resulted in more improvements of overall survival in patients with colorectal cancer.”

However, as colon cancer rates decline in adults 50 years and older, both incidence and death rates are increasing in the under-50 population. “We’re seeing a scary trend of younger patients getting colorectal cancer,” remarks Dr. Boccia, “even down into the 20s.” However, at this point in time, there’s insufficient data to clearly identify the causation behind this trend.

 

Colorectal Cancer Risk Factors

According to a report from the Maryland Department of Health and Mental Hygiene, the incidence rate of colon cancer per 100,000 people in Maryland was 1,174 for men and 1,109 for women in 2012. When looking at new cases of CRC, research shows that incidence may be tied to habits and lifestyles. Among these lifestyle- associated risk factors are being overweight or obese, lack of physical activity, smoking, heavy alcohol use and certain types of diets.

As outlined by the American Cancer Society, other risk factors unrelated to lifestyle choices are personal and family histories of colorectal cancer or adenomatous polyps, having type 2 diabetes, possessing an inherited syndrome, such as Lynch Syndrome, and certain racial and ethnic backgrounds. In addition, Dr. Boccia notes that a personal history of inflammatory bowel disease may increase the risk for developing colorectal cancer. “Patients with ulcerative colitis have to be screened very frequently for colon cancer,” Dr. Boccia elucidates, “because of that high predisposition.”

 

Common CRC Treatments

“For early stage colorectal cancer, the treatment of choice is surgery,” says Dr. Boccia. In this stage, a group of abnormal cells, referred to as carcinoma in situ (CIS), can be removed by a polypectomy, or a part of the colon can be removed via a partial colectomy. Once the cancer has penetrated the wall of the colon and perhaps even grown into nearby tissue, patients of RCCA Maryland will typically undergo active surveillance – although other treatment options are offered to those with high-risk tumors, says Dr. Boccia.

Once the cancer has reached Stage III, patients are generally offered a form of chemotherapy for roughly six weeks. “FOLFOX is the adjuvant therapy of choice,” says Dr. Boccia, “and that we know will lower the incidence of recurrence by about 40-50%.” For Stage IV diseases, which make up about 20% of the cases that RCCA Maryland sees each year, chemotherapy, targeted therapy and even immunotherapy can be used to offer aggressive treatment. If they no longer respond to a particular drug, patients will be introduced to a new regimen.

In regards to new research and treatment options, Dr. Boccia concludes, “I have 50 to 60 clinical trials open at all times in the center, so we’re always looking actively for good, cutting-edge therapies and offering those to our patients.”

 

If you or someone you love has been diagnosed with colorectal cancer, schedule an appointment at one of RCCA’s 29 locations in New Jersey, Maryland or Connecticut for personalized, professional care.

Molecular Testing: Tailoring Treatment by Targeting Pathways

Phillip D. Reid, MD

 

What is molecular testing? How it is used in cancer care?

A.  As we learn how to treat specific subtypes of cancer more accurately, molecular testing, molecular medicine and molecular diagnostics are becoming more prominent in oncology.

In the past, once a cancer was diagnosed, we determined the organ where it started, how much cancer was in the body and where it was. We have since discovered many pathways through which a cancer develops. We now need to know not only the stage, type and origin of cancer, but also the pathway through which it developed and then target that pathway.

 

How does the pathway concept affect therapy selection?

A.  It enhances our ability to treat the cancer, but we now need extra testing on a patient’s particular cancer cells. The great thing about molecular testing is we get an answer specific for the individual, not just for everyone, for example, with lung cancer. But it does require more time for us to find the pathway. From the patient’s standpoint, diagnosis and stage are obtained, and then sometimes we have to send off the cancer cells for extra testing, which increases the time between diagnosis and treatment. But ultimately, a better sense is provided of what drug to use and when to use it, and there’s a much greater likelihood of devising specific, effective treatment.

 

For which types of cancer should molecular testing be used?

A.  Molecular testing has revolutionized every major cancer diagnosis. Patients with lung and breast cancer are the best candidates, but molecular testing also is useful in colon cancer, head-and-neck and bladder cancer, and some leukemias and myelomas.

 

What have been the main developments over the last two to three years with molecular testing?

A.  It’s becoming easier and more standardized to get molecular testing done. A patient receives a diagnosis and his or her cancer is sent off to a lab, which evaluates all known pathways for that cancer. A specific result is received. As the patient receives therapy, sometimes the cancer changes and he or she may need a second or third biopsy one to three years after the initial diagnosis to see what’s changed in the cancer, and then the treatment changes based on that result. We now see cancer as a moving target as it progresses, and we have to recalibrate every few years so that we’re shooting that target correctly.

 

What should patients know about molecular testing before proceeding?

A.  After a patient receives his or her staging diagnosis, the next question is, “What subtype of lung cancer do I have and what pathway did the cancer use to develop?” The patient needs to have patience, as that extra information may not arrive for two to four weeks, but that information can increase the chances of treatment success.

Also ask about clinical trials of cancer medications before beginning therapy, because we often know about upcoming medications that are effective and possibly better than what we have right now.

Colorectal Cancer Trends and Treatment

Ralph V. Boccia, MD, a cancer specialist at RCCA Maryland, provides some insight into recent colorectal cancer trends and treatments that are giving new hope to doctors, researchers and patients nationwide. Overall, Dr. Boccia finds much to be encouraged by, but also points to the need for awareness of a concerning development in the field of colorectal cancer.

 

How Far We’ve Come and Where We’re Going

As a whole, colorectal cancer rates have been dropping. According to the National Cancer Institute and Centers for Disease Control and Prevention, Maryland alone has seen a 2.6% decrease in the amount of new CRC patients diagnosed over a five-year period. Dr. Boccia believes this trend can be partly attributed to the following:

  • Widespread increase in colonoscopies and other CRC screening methods
  • Early detection and removal of polyps before they become cancerous
  • More cases being diagnosed at an early stage – when the cancer is more responsive to treatment

Despite the good news, it’s still projected that 2,358 Maryland residents will be diagnosed and that 927 people will die from the disease this year, says Dr. Boccia. Doctors have also been noticing an uncharacteristic increase in the amount of younger adults being diagnosed with CRC. Since it typically affects individuals above the age of 50, this emerging demographic has been cause for concern. But Dr. Boccia and his colleagues will continue to conduct research and make further strides in colorectal cancer care to better serve patients of all ages.

 

Current Treatment Options

Surgical innovations, targeted therapies, immunotherapies, chemotherapy and clinical trials are paving the way for more effective CRC solutions. Dr. Boccia explains, “We have a greater ability than ever before to individualize care, and to offer patients multi-modal treatment regimens that employ a variety of mechanisms of action to combat cancer by different means.”

 

Reducing Your Risk

Follow these tips to help reduce your risk for developing colorectal cancer:

  • Maintain a healthy weight
  • Stay physically active
  • Avoid smoking cigarettes and only drink alcohol in moderation
  • Get a CRC screening regularly
  • Consult a physician right away if you experience any CRC symptoms, such as blood in the stool and persistent abdominal pain
  • Manage other conditions that may increase your risk for CRC, like type 2 diabetes, inflammatory bowel disease and adenomatous polyps

 

If you or someone you love has been diagnosed with colorectal cancer, schedule an appointment at one of RCCA’s 29 locations in New Jersey, Maryland or Connecticut for personalized, professional care.

RCCA Earns URAC Accreditation In Specialty Pharmacy

[Hackensack, NJ] – RCCA is proud to announce that it has earned URAC accreditation in Specialty Pharmacy. URAC is the independent leader in promoting healthcare quality through accreditation, certification and measurement. By achieving this status, RCCA has demonstrated a comprehensive commitment to quality care, improved processes and better patient outcomes.

 

“URAC Accreditation is a testament to the commitment of delivering the highest level of quality standards to our patients and their caregivers,” said Terrill Jordan, President and CEO of RCCA. ”This type of commitment is the cornerstone of everything we do at RCCA,” he added.

Edward Licitra, MD, PhD, RCCA Chairperson of the Board and RCCA Pharmacy Medical Director and Eileen Peng, PharmD, Director of the RCCA Pharmacy agree that “this new recognition will allow us to continue to provide the highest level of patient care and convenience for the people that need it the most.”

 

“Pharmacy services have never played such an important role in the delivery of care as they do today. RCCA distinguishes itself for having voluntarily undergone a rigorous review of quality standards that earned it URAC accreditation,” said URAC President and CEO Kylanne Green. “Independent URAC accreditation shows RCCA is dedicated to quality and safety, and that it strives for a continual improvement of its services.”

ABOUT RCCA

Regional Cancer Care Associates (RCCA), one of the largest oncology physician networks in the United States, is transforming oncology care by ensuring that cancer patients have access to the highest-quality, most-comprehensive, cutting edge treatments in a compassionate and community-based setting. RCCA includes more than 100 cancer care specialists and is supported by 800 employees at more than 30 care delivery sites, providing care to more than 24,000 new patients annually and over 240,000 existing patients.  For more information visit: http://www.RCCA.com

About URAC

Founded in 1990, URAC is the independent leader in promoting healthcare quality through accreditation, certification and measurement. URAC is a nonprofit organization developing evidence-based measures and standards through inclusive engagement with a range of stakeholders committed to improving the quality of healthcare. Our portfolio of accreditation and certification programs span the healthcare industry, addressing healthcare management, healthcare operations, health plans, pharmacies, telehealth providers, physician practices, and more. URAC accreditation is a symbol of excellence for organizations to showcase their validated commitment to quality and accountability.

For further information, contact:

Mary Lou Salvemini
msalvemini@regionalcancercare.org
(201) 510-0922

RCCA Makes Innovative UnitedHealthcare Cancer Care Program Available to Patients in Maryland

HACKENSACK, N.J., Nov. 22, 2016 /PRNewswire-USNewswire/ — Regional Cancer Care Associates (RCCA) is expanding its cancer care payment initiative with UnitedHealthcare to RCCA patients in Maryland who are covered by UnitedHealthcare benefit plans.

The program, made available at RCCA New Jersey locations in January, rewards physicians for focusing on best treatment practices, quality patient care and better health outcomes. The program pays participating medical oncologists more if they demonstrate superior clinical results and if they reduce the total cost of care.

The episode payment model shifts reimbursement away from the current “fee-for-service” approach that emphasizes volume of care delivered regardless of a patient’s health outcomes. The episode payment is based on the expected cost of a standard treatment regimen for a specific condition, as predetermined by the doctor. Similar payment models have been shown to enhance care coordination and improve health outcomes for patients, while reducing overall costs.

“RCCA has emerged as a leader in delivering the highest-level quality cancer care to our patients,” said Terrill Jordan, RCCA President and CEO. “New payment methodologies like this put patients’ interests at the forefront of cancer treatment. It also results in significant cost savings, which advances efforts across the country to assist in controlling rising health care costs. We are excited to offer this program to our Maryland patient base.”

Lee N. Newcomer, M.D., UnitedHealthcare’s Senior Vice President, Oncology, said: “Our partnership with RCCA marks an important step toward expanded episode payment models and away from the traditional fee-for-service payments for oncology care. We look forward to working with RCCA and others to expand our efforts to identify best practices for treating cancer.”

A study published in the Journal of Oncology Practice has demonstrated that this program reduced overall cancer expenses by more than a third while improving quality outcomes. RCCA is among five oncology practices that have joined the program, which now has a total of more than 650 oncologists. RCCA in New Jersey and now Maryland comprise approximately 100 of these oncologists.

“Value-based cancer care is here. This program will enable Maryland-based RCCA oncologists to continue to provide patient-centered care at the highest level of quality,” said Ralph Boccia, M.D., RCCA Research Deputy Chair and Oncologist in Bethesda and Germantown, Md.

UnitedHealthcare first implemented its episode payment program as a pilot study between October 2009 and December 2012. The pilot study produced a significant reduction in hospitalizations and a 34 percent reduction in total costs while improving quality. Click here to read results of the study.

About RCCA
Regional Cancer Care Associates (RCCA), one of the largest oncology physician networks in the United States, is transforming oncology care by ensuring that cancer patients have access to the highest-quality, most-comprehensive, cutting edge treatments in a compassionate and community-based setting. RCCA includes 100 cancer care specialists and is supported by 700 employees at 27 care delivery sites, providing care to more than 230,000 existing patients in New Jersey, Maryland and Washington DC.  For more information visit: http://www.RCCA.com

Contact:

Mary Lou Salvemini
msalvemini@regionalcancercare.org
(201) 510-0922

REGIONAL CANCER CARE ASSOCIATES AND AETNA FORM ONCOLOGY MEDICAL HOME

REGIONAL CANCER CARE ASSOCIATES AND AETNA FORM ONCOLOGY MEDICAL HOME

— The Patient-Focused Model Supports High-Value Care–

 

Hackensack, NJ, October 12, 2016 — Regional Cancer Care Associates (RCCA) and Aetna (NYSE: AET) announced a collaboration to create an oncology medical home that is designed to improve the care experience for cancer patients.

In the oncology medical home model, teams of cancer specialists collectively provide a patient’s health care when he or she has a cancer diagnosis. The model will give RCCA the responsibility to arrange appropriate care that is continuous and proactive and physicians will be incentivized for improved health, affordability and a better patient experience.

The oncology medical home arrangement will be available to patients at all RCCA locations in New Jersey and Maryland.

“RCCA is excited to partner with Aetna on this program. It aligns with our vision of providing patient centered care close to home,” said Terrill Jordan, RCCA President & CEO. “This partnership will not only enable us to continue the delivery of high quality care through reduced side effects, but will also facilitate cost effective care based on the data Aetna will be sharing,” said Michael Ruiz de Somocurcio, RCCA Vice President of Payer and Provider Collaboration.

The model is part of a strategic direction to transition from fee-for-service medicine to value-based payment. Value-based arrangements are emerging as a solution to address rising health care costs, clinical inefficiency, duplication of services, and access to care. In value-based models, doctors and hospitals are paid for helping to keep people healthy and for improving the health of those who have chronic conditions in an evidence-based, cost-effective way.

“We understand that cancer treatment can be the hardest experience that our members will ever have to go through,” said Daniel Knecht, M.D., M.B.A., Aetna’s Head of Strategy & Planning and Interim Head of Oncology Solutions. “This oncology medical home with RCCA will help provide our members with high-quality care and an optimal patient experience.”

The operating principles of the RCCA and Aetna oncology medical home include:

  • An orientation to the whole person. A personal physician from RCCA will be responsible for providing or arranging all of a patient’s health care needs with other qualified professionals. This includes care for all stages of treatment: preventive services, acute care, chronic care, palliative care and end-of-life care.
  • Evidence-based, personalized medical care. The RCCA team will focus on making treatment decisions based on current medical evidence for each unique disease presentation, patient-specific factors and patient choice using appropriate treatments to improve quality and outcomes.
  • Coordinated and integrated care. Care will be facilitated, across all elements of the health system, to enable Aetna members to get the appropriate care when and where it is needed and wanted, in a culturally and linguistically appropriate manner.
  • Quality and safety. Quality and safety will be a focus of care, including the use of evidence-based medicine, clinical decision support tools and accountability for continuous quality improvement.
  • Enhanced access to care. Care will be available through systems such as open scheduling, expanded hours and new options for communication between Aetna members, their personal physicians and hospital staff.

The oncology medical home arrangement launched in September 2016.

About RCCA

Regional Cancer Care Associates (RCCA), one of the largest oncology physician networks in the United States, is transforming oncology care by ensuring that cancer patients have access to the highest-quality, most-comprehensive, cutting edge treatments in a compassionate and community-based setting. RCCA includes 100 cancer care specialists and is supported by 700 employees at 27 care delivery sites, providing care to more than 23,000 new patients annually and over 230,000 existing patients in New Jersey, Maryland and Washington DC. For more information visit: http://www.RCCA.com.

About Aetna

Aetna is one of the nation’s leading diversified health care benefits companies, serving an estimated 46.3 million people with information and resources to help them make better informed decisions about their health care. Aetna offers a broad range of traditional, voluntary and consumer-directed health insurance products and related services, including medical, pharmacy, dental, behavioral health, group life and disability plans, and medical management capabilities, Medicaid health care management services, workers’ compensation administrative services and health information technology products and services. Aetna’s customers include employer groups, individuals, college students, part-time and hourly workers, health plans, health care providers, governmental units, government-sponsored plans, labor groups and expatriates. For more information, see www.aetna.com and learn about how Aetna is helping to build a healthier world. @AetnaNews

 

###

What Cancer Patients Need To Know About Clinical Trials: Insights From New Jersey Hematologist /Oncologist Seth Berk

Seth Howard Berk, MD, a hematologist and medical oncologist with RCCA, reveals four facts that he shares with his patients when they ask about clinical trials.

First, a drug has been thoroughly tested well before it reaches the clinical trial stage. Pre-clinical trial testing involves looking at a drug’s effects on animals as well as human cells. This stage usually takes years of development. Also, the clinical studies have to be designed and conducted in accordance with rigorous ethical and safety criteria.

He also imparts the importance of not thinking of clinical trials as a last resort in treatment. While trials are typically suited for situations in which traditional therapy methods are not working for a patient, there is more evidence emerging of late-stage trials benefitting the patient when used early in the diagnosis process.

A myth that Dr. Berk debunks is the use of a placebo in cancer treatment. Some cancer patients are resistant to clinical trials because they fear there will be a placebo and they will suffer as a result. He says this is misinformation or something assumed from a patient’s memory of high school or college science experiments. In clinical trials, one group will be administered the trial agent while the other continues to have traditional therapy. There are rarely ever patients receiving zero care.

Lastly, Dr. Berk addresses the importance of clinical trials for cancer patients in general. Because of willing patients participating in more and more trials, doctors and patients can share in a community of knowledge and understanding, and, one day, a cure.

To read more about clinical trials, turn to “What cancer patients need to know about clinical trials: Insights from New Jersey oncologist/hematologist Seth Berk.”

RCCA: Taking Cancer Care To A Higher Level In NJ And Beyond

Edward J. Licitra, MD, PhD, board certified in internal medicine, hematology and medical oncology and chairman of the board of directors of Regional Cancer Care Associates (RCCA), shares some of his thoughts on potential models for a health care delivery reform system. Oncologists at RCCA, totaling 100 physicians, learn from each other’s best practices with the patient’s interest at the forefront. Through RCCA, patients can receive care at home instead of visiting a hospital or clinic. They have set up 27 care delivery sites, providing care to more than 23,000 new patients annually and approximately 230,000 existing patients in New Jersey, Maryland and Washington, D.C.

Another example of a successful care reform case is the Oncology Care Model (OCM) created by Medicare under the Affordable Care Act (ACA). The model questions how to best develop an integrated style of cancer care. It focuses on developing a care model for the future, using data sharing and streamlining economics for patients as well as providers. By digitizing patients’ medical histories and sharing them through hospitals and clinics, this model focuses on simplifying the oncology care process.

Lastly, the OCM utilizes evidence-based-medicine (EBM) practices throughout the entire spectrum of care. EBM produces the best methods regardless of cost, while even reducing cost by eliminating wasteful spending. The OCM focuses on patient-focused, research based therapy tailored to the individual patient.

To learn more about this topic, read “RCCA: Taking cancer care to a higher level in NJ and beyond.”

Targeting Treatments for Chronic Lymphocytic Leukemia

Dr. Joel Silver

 

How do myeloma and chronic lymphocytic leukemia (CLL) develop? What are some risk factors associated with those malignancies?

A. We don’t know what causes CLL. We do know that people in some occupations or with a certain exposure history might be at higher risk, and that CLL generally affects older people. Treatment fortunately is not needed in many cases, but even so our treatment options have evolved based on cytogenetics and next-generation sequencing. We have more ways to assess prognostic features and design more personalized and potentially more effective therapy for people with CLL.

 

What therapies have been successful in treating CLL over the last two to three years?

A. If you can identify a certain kind of CLL, such as IDH-mutated CLL, some of the patients with it can receive a standard chemotherapy regimen called FCR, and they sometimes go into remission indefinitely. It depends on whether the patient is young and healthy enough to tolerate the therapy. That’s a select group, though; you don’t see too many young people with CLL.

Years ago, an effective treatment did not exist for another group of patients with CLL, those with the genetic 17p deletion. In recent years, however, the oral agent ibrutinib has shown effectiveness for CLL in this group. Other therapies now are available for patients who don’t respond to ibrutinib.

 

Where does targeted therapy come into play?

A. In general, “targeted therapy” refers to a treatment based on a particular mutation or pattern. The presence of the genetic 17p deletion in CLL is one example, but this is a bad cytogenetic abnormality for which standard treatments such as chemotherapy haven’t worked. If we can identify a particular mutation, then we can target our therapy and plan treatment that we know will work, instead of going through chemotherapies that are only partially effective or downright ineffective and then finding that the patient is resistant to treatment.

 

Are there side effects or drawbacks to targeted therapy?

A. Everything we do has side effects. The oral agent ibrutinib has been an effective first-line therapy for any type of CLL. Although the agent is specifically for patients with 17p deletion, it has also worked for patients without that genetic feature. While some cardiovascular and bleeding issues have been reported, ibrutinib overall is more tolerable than chemotherapy.

When we medically examine patients with CLL, we always look at a pattern of mutations to try to identify how to treat these people — not so much from an immediate therapeutic standpoint, but to gain knowledge of all these other cytogenetic abnormalities so that eventually, we will find other ways to target those different patterns.

What important points do you address with patients before they begin CLL therapy?

A. Many people with CLL don’t die of their disease, they die with their disease, so I tell patients not to be afraid of the disease itself. Many of the conversations we have with these people, however, revolve around the fact that they have this problem but may never need treatment. “We should follow you because you may need treatment down the line,” I tell them. “If you need treatment, we have many effective therapies.”

 

Do you foresee different therapies for CLL emerging within the next two to three years?

A. A number of medications are on the horizon that will be appropriate for any patient with CLL. For example, venetoclax, which gained FDA approval last year, is indicated for second-line treatment of CLL in patients with the 17p deletion, but I think that agent will be effective for all patients with CLL. As similarly versatile agents are developed, we will have many more treatment options.

Colorectal Cancer Trends in Maryland: A Conversation with Dr. Ralph V. Boccia

As the third most common cancer in the United States, colorectal cancer (CRC) affects about 1 in 20 Americans. However, incidence and death rates for cancer of the colorectum have significantly decreased over the past several decades as a result of increased screening and drastic improvements in treatment. In Maryland alone, approximately 70% of adults over the age of 50 have an up-to-date colorectal cancer screening, helping contribute to the reduction in mortality rates.

Dr. Ralph V. Boccia, an oncology and hematology specialist at Regional Cancer Care Associates (RCCA) in Bethesda and Germantown, Maryland says, “The more colorectal screening we have and the earlier it gets started, the lower the stage that the cancer is typically picked up.” In turn, early detection has led to the state’s lower mortality rates over time.

 

The Benefits Of Increased Screening

According to Dr. Boccia, improving screening rates “affects the stage at which the cancer presents itself and [the patient’s] potential for survival.” Between 2002 and 2010, the percentage of Maryland adults with up-to-date colorectal cancer screenings increased from 64% to 71%. As a result, CRC mortality rates in Maryland decreased considerably among both men and women in that eight-year timeframe. Dr. Boccia explains, “The trend we’ve actually seen – which is that more people are being screened – has resulted in more improvements of overall survival in patients with colorectal cancer.”

However, as colon cancer rates decline in adults 50 years and older, both incidence and death rates are increasing in the under-50 population. “We’re seeing a scary trend of younger patients getting colorectal cancer,” remarks Dr. Boccia, “even down into the 20s.” However, at this point in time, there’s insufficient data to clearly identify the causation behind this trend.

 

Colorectal Cancer Risk Factors

According to a report from the Maryland Department of Health and Mental Hygiene, the incidence rate of colon cancer per 100,000 people in Maryland was 1,174 for men and 1,109 for women in 2012. When looking at new cases of CRC, research shows that incidence may be tied to habits and lifestyles. Among these lifestyle- associated risk factors are being overweight or obese, lack of physical activity, smoking, heavy alcohol use and certain types of diets.

As outlined by the American Cancer Society, other risk factors unrelated to lifestyle choices are personal and family histories of colorectal cancer or adenomatous polyps, having type 2 diabetes, possessing an inherited syndrome, such as Lynch Syndrome, and certain racial and ethnic backgrounds. In addition, Dr. Boccia notes that a personal history of inflammatory bowel disease may increase the risk for developing colorectal cancer. “Patients with ulcerative colitis have to be screened very frequently for colon cancer,” Dr. Boccia elucidates, “because of that high predisposition.”

 

Common CRC Treatments

“For early stage colorectal cancer, the treatment of choice is surgery,” says Dr. Boccia. In this stage, a group of abnormal cells, referred to as carcinoma in situ (CIS), can be removed by a polypectomy, or a part of the colon can be removed via a partial colectomy. Once the cancer has penetrated the wall of the colon and perhaps even grown into nearby tissue, patients of RCCA Maryland will typically undergo active surveillance – although other treatment options are offered to those with high-risk tumors, says Dr. Boccia.

Once the cancer has reached Stage III, patients are generally offered a form of chemotherapy for roughly six weeks. “FOLFOX is the adjuvant therapy of choice,” says Dr. Boccia, “and that we know will lower the incidence of recurrence by about 40-50%.” For Stage IV diseases, which make up about 20% of the cases that RCCA Maryland sees each year, chemotherapy, targeted therapy and even immunotherapy can be used to offer aggressive treatment. If they no longer respond to a particular drug, patients will be introduced to a new regimen.

In regards to new research and treatment options, Dr. Boccia concludes, “I have 50 to 60 clinical trials open at all times in the center, so we’re always looking actively for good, cutting-edge therapies and offering those to our patients.”

 

If you or someone you love has been diagnosed with colorectal cancer, schedule an appointment at one of RCCA’s 29 locations in New Jersey, Maryland or Connecticut for personalized, professional care.

Molecular Testing: Tailoring Treatment by Targeting Pathways

Phillip D. Reid, MD

 

What is molecular testing? How it is used in cancer care?

A.  As we learn how to treat specific subtypes of cancer more accurately, molecular testing, molecular medicine and molecular diagnostics are becoming more prominent in oncology.

In the past, once a cancer was diagnosed, we determined the organ where it started, how much cancer was in the body and where it was. We have since discovered many pathways through which a cancer develops. We now need to know not only the stage, type and origin of cancer, but also the pathway through which it developed and then target that pathway.

 

How does the pathway concept affect therapy selection?

A.  It enhances our ability to treat the cancer, but we now need extra testing on a patient’s particular cancer cells. The great thing about molecular testing is we get an answer specific for the individual, not just for everyone, for example, with lung cancer. But it does require more time for us to find the pathway. From the patient’s standpoint, diagnosis and stage are obtained, and then sometimes we have to send off the cancer cells for extra testing, which increases the time between diagnosis and treatment. But ultimately, a better sense is provided of what drug to use and when to use it, and there’s a much greater likelihood of devising specific, effective treatment.

 

For which types of cancer should molecular testing be used?

A.  Molecular testing has revolutionized every major cancer diagnosis. Patients with lung and breast cancer are the best candidates, but molecular testing also is useful in colon cancer, head-and-neck and bladder cancer, and some leukemias and myelomas.

 

What have been the main developments over the last two to three years with molecular testing?

A.  It’s becoming easier and more standardized to get molecular testing done. A patient receives a diagnosis and his or her cancer is sent off to a lab, which evaluates all known pathways for that cancer. A specific result is received. As the patient receives therapy, sometimes the cancer changes and he or she may need a second or third biopsy one to three years after the initial diagnosis to see what’s changed in the cancer, and then the treatment changes based on that result. We now see cancer as a moving target as it progresses, and we have to recalibrate every few years so that we’re shooting that target correctly.

 

What should patients know about molecular testing before proceeding?

A.  After a patient receives his or her staging diagnosis, the next question is, “What subtype of lung cancer do I have and what pathway did the cancer use to develop?” The patient needs to have patience, as that extra information may not arrive for two to four weeks, but that information can increase the chances of treatment success.

Also ask about clinical trials of cancer medications before beginning therapy, because we often know about upcoming medications that are effective and possibly better than what we have right now.

Colorectal Cancer Trends and Treatment

Ralph V. Boccia, MD, a cancer specialist at RCCA Maryland, provides some insight into recent colorectal cancer trends and treatments that are giving new hope to doctors, researchers and patients nationwide. Overall, Dr. Boccia finds much to be encouraged by, but also points to the need for awareness of a concerning development in the field of colorectal cancer.

 

How Far We’ve Come and Where We’re Going

As a whole, colorectal cancer rates have been dropping. According to the National Cancer Institute and Centers for Disease Control and Prevention, Maryland alone has seen a 2.6% decrease in the amount of new CRC patients diagnosed over a five-year period. Dr. Boccia believes this trend can be partly attributed to the following:

  • Widespread increase in colonoscopies and other CRC screening methods
  • Early detection and removal of polyps before they become cancerous
  • More cases being diagnosed at an early stage – when the cancer is more responsive to treatment

Despite the good news, it’s still projected that 2,358 Maryland residents will be diagnosed and that 927 people will die from the disease this year, says Dr. Boccia. Doctors have also been noticing an uncharacteristic increase in the amount of younger adults being diagnosed with CRC. Since it typically affects individuals above the age of 50, this emerging demographic has been cause for concern. But Dr. Boccia and his colleagues will continue to conduct research and make further strides in colorectal cancer care to better serve patients of all ages.

 

Current Treatment Options

Surgical innovations, targeted therapies, immunotherapies, chemotherapy and clinical trials are paving the way for more effective CRC solutions. Dr. Boccia explains, “We have a greater ability than ever before to individualize care, and to offer patients multi-modal treatment regimens that employ a variety of mechanisms of action to combat cancer by different means.”

 

Reducing Your Risk

Follow these tips to help reduce your risk for developing colorectal cancer:

  • Maintain a healthy weight
  • Stay physically active
  • Avoid smoking cigarettes and only drink alcohol in moderation
  • Get a CRC screening regularly
  • Consult a physician right away if you experience any CRC symptoms, such as blood in the stool and persistent abdominal pain
  • Manage other conditions that may increase your risk for CRC, like type 2 diabetes, inflammatory bowel disease and adenomatous polyps

 

If you or someone you love has been diagnosed with colorectal cancer, schedule an appointment at one of RCCA’s 29 locations in New Jersey, Maryland or Connecticut for personalized, professional care.

RCCA Earns URAC Accreditation In Specialty Pharmacy

[Hackensack, NJ] – RCCA is proud to announce that it has earned URAC accreditation in Specialty Pharmacy. URAC is the independent leader in promoting healthcare quality through accreditation, certification and measurement. By achieving this status, RCCA has demonstrated a comprehensive commitment to quality care, improved processes and better patient outcomes.

 

“URAC Accreditation is a testament to the commitment of delivering the highest level of quality standards to our patients and their caregivers,” said Terrill Jordan, President and CEO of RCCA. ”This type of commitment is the cornerstone of everything we do at RCCA,” he added.

Edward Licitra, MD, PhD, RCCA Chairperson of the Board and RCCA Pharmacy Medical Director and Eileen Peng, PharmD, Director of the RCCA Pharmacy agree that “this new recognition will allow us to continue to provide the highest level of patient care and convenience for the people that need it the most.”

 

“Pharmacy services have never played such an important role in the delivery of care as they do today. RCCA distinguishes itself for having voluntarily undergone a rigorous review of quality standards that earned it URAC accreditation,” said URAC President and CEO Kylanne Green. “Independent URAC accreditation shows RCCA is dedicated to quality and safety, and that it strives for a continual improvement of its services.”

ABOUT RCCA

Regional Cancer Care Associates (RCCA), one of the largest oncology physician networks in the United States, is transforming oncology care by ensuring that cancer patients have access to the highest-quality, most-comprehensive, cutting edge treatments in a compassionate and community-based setting. RCCA includes more than 100 cancer care specialists and is supported by 800 employees at more than 30 care delivery sites, providing care to more than 24,000 new patients annually and over 240,000 existing patients.  For more information visit: http://www.RCCA.com

About URAC

Founded in 1990, URAC is the independent leader in promoting healthcare quality through accreditation, certification and measurement. URAC is a nonprofit organization developing evidence-based measures and standards through inclusive engagement with a range of stakeholders committed to improving the quality of healthcare. Our portfolio of accreditation and certification programs span the healthcare industry, addressing healthcare management, healthcare operations, health plans, pharmacies, telehealth providers, physician practices, and more. URAC accreditation is a symbol of excellence for organizations to showcase their validated commitment to quality and accountability.

For further information, contact:

Mary Lou Salvemini
msalvemini@regionalcancercare.org
(201) 510-0922

RCCA Makes Innovative UnitedHealthcare Cancer Care Program Available to Patients in Maryland

HACKENSACK, N.J., Nov. 22, 2016 /PRNewswire-USNewswire/ — Regional Cancer Care Associates (RCCA) is expanding its cancer care payment initiative with UnitedHealthcare to RCCA patients in Maryland who are covered by UnitedHealthcare benefit plans.

The program, made available at RCCA New Jersey locations in January, rewards physicians for focusing on best treatment practices, quality patient care and better health outcomes. The program pays participating medical oncologists more if they demonstrate superior clinical results and if they reduce the total cost of care.

The episode payment model shifts reimbursement away from the current “fee-for-service” approach that emphasizes volume of care delivered regardless of a patient’s health outcomes. The episode payment is based on the expected cost of a standard treatment regimen for a specific condition, as predetermined by the doctor. Similar payment models have been shown to enhance care coordination and improve health outcomes for patients, while reducing overall costs.

“RCCA has emerged as a leader in delivering the highest-level quality cancer care to our patients,” said Terrill Jordan, RCCA President and CEO. “New payment methodologies like this put patients’ interests at the forefront of cancer treatment. It also results in significant cost savings, which advances efforts across the country to assist in controlling rising health care costs. We are excited to offer this program to our Maryland patient base.”

Lee N. Newcomer, M.D., UnitedHealthcare’s Senior Vice President, Oncology, said: “Our partnership with RCCA marks an important step toward expanded episode payment models and away from the traditional fee-for-service payments for oncology care. We look forward to working with RCCA and others to expand our efforts to identify best practices for treating cancer.”

A study published in the Journal of Oncology Practice has demonstrated that this program reduced overall cancer expenses by more than a third while improving quality outcomes. RCCA is among five oncology practices that have joined the program, which now has a total of more than 650 oncologists. RCCA in New Jersey and now Maryland comprise approximately 100 of these oncologists.

“Value-based cancer care is here. This program will enable Maryland-based RCCA oncologists to continue to provide patient-centered care at the highest level of quality,” said Ralph Boccia, M.D., RCCA Research Deputy Chair and Oncologist in Bethesda and Germantown, Md.

UnitedHealthcare first implemented its episode payment program as a pilot study between October 2009 and December 2012. The pilot study produced a significant reduction in hospitalizations and a 34 percent reduction in total costs while improving quality. Click here to read results of the study.

About RCCA
Regional Cancer Care Associates (RCCA), one of the largest oncology physician networks in the United States, is transforming oncology care by ensuring that cancer patients have access to the highest-quality, most-comprehensive, cutting edge treatments in a compassionate and community-based setting. RCCA includes 100 cancer care specialists and is supported by 700 employees at 27 care delivery sites, providing care to more than 230,000 existing patients in New Jersey, Maryland and Washington DC.  For more information visit: http://www.RCCA.com

Contact:

Mary Lou Salvemini
msalvemini@regionalcancercare.org
(201) 510-0922

REGIONAL CANCER CARE ASSOCIATES AND AETNA FORM ONCOLOGY MEDICAL HOME

REGIONAL CANCER CARE ASSOCIATES AND AETNA FORM ONCOLOGY MEDICAL HOME

— The Patient-Focused Model Supports High-Value Care–

 

Hackensack, NJ, October 12, 2016 — Regional Cancer Care Associates (RCCA) and Aetna (NYSE: AET) announced a collaboration to create an oncology medical home that is designed to improve the care experience for cancer patients.

In the oncology medical home model, teams of cancer specialists collectively provide a patient’s health care when he or she has a cancer diagnosis. The model will give RCCA the responsibility to arrange appropriate care that is continuous and proactive and physicians will be incentivized for improved health, affordability and a better patient experience.

The oncology medical home arrangement will be available to patients at all RCCA locations in New Jersey and Maryland.

“RCCA is excited to partner with Aetna on this program. It aligns with our vision of providing patient centered care close to home,” said Terrill Jordan, RCCA President & CEO. “This partnership will not only enable us to continue the delivery of high quality care through reduced side effects, but will also facilitate cost effective care based on the data Aetna will be sharing,” said Michael Ruiz de Somocurcio, RCCA Vice President of Payer and Provider Collaboration.

The model is part of a strategic direction to transition from fee-for-service medicine to value-based payment. Value-based arrangements are emerging as a solution to address rising health care costs, clinical inefficiency, duplication of services, and access to care. In value-based models, doctors and hospitals are paid for helping to keep people healthy and for improving the health of those who have chronic conditions in an evidence-based, cost-effective way.

“We understand that cancer treatment can be the hardest experience that our members will ever have to go through,” said Daniel Knecht, M.D., M.B.A., Aetna’s Head of Strategy & Planning and Interim Head of Oncology Solutions. “This oncology medical home with RCCA will help provide our members with high-quality care and an optimal patient experience.”

The operating principles of the RCCA and Aetna oncology medical home include:

  • An orientation to the whole person. A personal physician from RCCA will be responsible for providing or arranging all of a patient’s health care needs with other qualified professionals. This includes care for all stages of treatment: preventive services, acute care, chronic care, palliative care and end-of-life care.
  • Evidence-based, personalized medical care. The RCCA team will focus on making treatment decisions based on current medical evidence for each unique disease presentation, patient-specific factors and patient choice using appropriate treatments to improve quality and outcomes.
  • Coordinated and integrated care. Care will be facilitated, across all elements of the health system, to enable Aetna members to get the appropriate care when and where it is needed and wanted, in a culturally and linguistically appropriate manner.
  • Quality and safety. Quality and safety will be a focus of care, including the use of evidence-based medicine, clinical decision support tools and accountability for continuous quality improvement.
  • Enhanced access to care. Care will be available through systems such as open scheduling, expanded hours and new options for communication between Aetna members, their personal physicians and hospital staff.

The oncology medical home arrangement launched in September 2016.

About RCCA

Regional Cancer Care Associates (RCCA), one of the largest oncology physician networks in the United States, is transforming oncology care by ensuring that cancer patients have access to the highest-quality, most-comprehensive, cutting edge treatments in a compassionate and community-based setting. RCCA includes 100 cancer care specialists and is supported by 700 employees at 27 care delivery sites, providing care to more than 23,000 new patients annually and over 230,000 existing patients in New Jersey, Maryland and Washington DC. For more information visit: http://www.RCCA.com.

About Aetna

Aetna is one of the nation’s leading diversified health care benefits companies, serving an estimated 46.3 million people with information and resources to help them make better informed decisions about their health care. Aetna offers a broad range of traditional, voluntary and consumer-directed health insurance products and related services, including medical, pharmacy, dental, behavioral health, group life and disability plans, and medical management capabilities, Medicaid health care management services, workers’ compensation administrative services and health information technology products and services. Aetna’s customers include employer groups, individuals, college students, part-time and hourly workers, health plans, health care providers, governmental units, government-sponsored plans, labor groups and expatriates. For more information, see www.aetna.com and learn about how Aetna is helping to build a healthier world. @AetnaNews

 

###

What Cancer Patients Need To Know About Clinical Trials: Insights From New Jersey Hematologist /Oncologist Seth Berk

Seth Howard Berk, MD, a hematologist and medical oncologist with RCCA, reveals four facts that he shares with his patients when they ask about clinical trials.

First, a drug has been thoroughly tested well before it reaches the clinical trial stage. Pre-clinical trial testing involves looking at a drug’s effects on animals as well as human cells. This stage usually takes years of development. Also, the clinical studies have to be designed and conducted in accordance with rigorous ethical and safety criteria.

He also imparts the importance of not thinking of clinical trials as a last resort in treatment. While trials are typically suited for situations in which traditional therapy methods are not working for a patient, there is more evidence emerging of late-stage trials benefitting the patient when used early in the diagnosis process.

A myth that Dr. Berk debunks is the use of a placebo in cancer treatment. Some cancer patients are resistant to clinical trials because they fear there will be a placebo and they will suffer as a result. He says this is misinformation or something assumed from a patient’s memory of high school or college science experiments. In clinical trials, one group will be administered the trial agent while the other continues to have traditional therapy. There are rarely ever patients receiving zero care.

Lastly, Dr. Berk addresses the importance of clinical trials for cancer patients in general. Because of willing patients participating in more and more trials, doctors and patients can share in a community of knowledge and understanding, and, one day, a cure.

To read more about clinical trials, turn to “What cancer patients need to know about clinical trials: Insights from New Jersey oncologist/hematologist Seth Berk.”

RCCA: Taking Cancer Care To A Higher Level In NJ And Beyond

Edward J. Licitra, MD, PhD, board certified in internal medicine, hematology and medical oncology and chairman of the board of directors of Regional Cancer Care Associates (RCCA), shares some of his thoughts on potential models for a health care delivery reform system. Oncologists at RCCA, totaling 100 physicians, learn from each other’s best practices with the patient’s interest at the forefront. Through RCCA, patients can receive care at home instead of visiting a hospital or clinic. They have set up 27 care delivery sites, providing care to more than 23,000 new patients annually and approximately 230,000 existing patients in New Jersey, Maryland and Washington, D.C.

Another example of a successful care reform case is the Oncology Care Model (OCM) created by Medicare under the Affordable Care Act (ACA). The model questions how to best develop an integrated style of cancer care. It focuses on developing a care model for the future, using data sharing and streamlining economics for patients as well as providers. By digitizing patients’ medical histories and sharing them through hospitals and clinics, this model focuses on simplifying the oncology care process.

Lastly, the OCM utilizes evidence-based-medicine (EBM) practices throughout the entire spectrum of care. EBM produces the best methods regardless of cost, while even reducing cost by eliminating wasteful spending. The OCM focuses on patient-focused, research based therapy tailored to the individual patient.

To learn more about this topic, read “RCCA: Taking cancer care to a higher level in NJ and beyond.”

Targeting Treatments for Chronic Lymphocytic Leukemia

Dr. Joel Silver

 

How do myeloma and chronic lymphocytic leukemia (CLL) develop? What are some risk factors associated with those malignancies?

A. We don’t know what causes CLL. We do know that people in some occupations or with a certain exposure history might be at higher risk, and that CLL generally affects older people. Treatment fortunately is not needed in many cases, but even so our treatment options have evolved based on cytogenetics and next-generation sequencing. We have more ways to assess prognostic features and design more personalized and potentially more effective therapy for people with CLL.

 

What therapies have been successful in treating CLL over the last two to three years?

A. If you can identify a certain kind of CLL, such as IDH-mutated CLL, some of the patients with it can receive a standard chemotherapy regimen called FCR, and they sometimes go into remission indefinitely. It depends on whether the patient is young and healthy enough to tolerate the therapy. That’s a select group, though; you don’t see too many young people with CLL.

Years ago, an effective treatment did not exist for another group of patients with CLL, those with the genetic 17p deletion. In recent years, however, the oral agent ibrutinib has shown effectiveness for CLL in this group. Other therapies now are available for patients who don’t respond to ibrutinib.

 

Where does targeted therapy come into play?

A. In general, “targeted therapy” refers to a treatment based on a particular mutation or pattern. The presence of the genetic 17p deletion in CLL is one example, but this is a bad cytogenetic abnormality for which standard treatments such as chemotherapy haven’t worked. If we can identify a particular mutation, then we can target our therapy and plan treatment that we know will work, instead of going through chemotherapies that are only partially effective or downright ineffective and then finding that the patient is resistant to treatment.

 

Are there side effects or drawbacks to targeted therapy?

A. Everything we do has side effects. The oral agent ibrutinib has been an effective first-line therapy for any type of CLL. Although the agent is specifically for patients with 17p deletion, it has also worked for patients without that genetic feature. While some cardiovascular and bleeding issues have been reported, ibrutinib overall is more tolerable than chemotherapy.

When we medically examine patients with CLL, we always look at a pattern of mutations to try to identify how to treat these people — not so much from an immediate therapeutic standpoint, but to gain knowledge of all these other cytogenetic abnormalities so that eventually, we will find other ways to target those different patterns.

What important points do you address with patients before they begin CLL therapy?

A. Many people with CLL don’t die of their disease, they die with their disease, so I tell patients not to be afraid of the disease itself. Many of the conversations we have with these people, however, revolve around the fact that they have this problem but may never need treatment. “We should follow you because you may need treatment down the line,” I tell them. “If you need treatment, we have many effective therapies.”

 

Do you foresee different therapies for CLL emerging within the next two to three years?

A. A number of medications are on the horizon that will be appropriate for any patient with CLL. For example, venetoclax, which gained FDA approval last year, is indicated for second-line treatment of CLL in patients with the 17p deletion, but I think that agent will be effective for all patients with CLL. As similarly versatile agents are developed, we will have many more treatment options.

Colorectal Cancer Trends in Maryland: A Conversation with Dr. Ralph V. Boccia

As the third most common cancer in the United States, colorectal cancer (CRC) affects about 1 in 20 Americans. However, incidence and death rates for cancer of the colorectum have significantly decreased over the past several decades as a result of increased screening and drastic improvements in treatment. In Maryland alone, approximately 70% of adults over the age of 50 have an up-to-date colorectal cancer screening, helping contribute to the reduction in mortality rates.

Dr. Ralph V. Boccia, an oncology and hematology specialist at Regional Cancer Care Associates (RCCA) in Bethesda and Germantown, Maryland says, “The more colorectal screening we have and the earlier it gets started, the lower the stage that the cancer is typically picked up.” In turn, early detection has led to the state’s lower mortality rates over time.

 

The Benefits Of Increased Screening

According to Dr. Boccia, improving screening rates “affects the stage at which the cancer presents itself and [the patient’s] potential for survival.” Between 2002 and 2010, the percentage of Maryland adults with up-to-date colorectal cancer screenings increased from 64% to 71%. As a result, CRC mortality rates in Maryland decreased considerably among both men and women in that eight-year timeframe. Dr. Boccia explains, “The trend we’ve actually seen – which is that more people are being screened – has resulted in more improvements of overall survival in patients with colorectal cancer.”

However, as colon cancer rates decline in adults 50 years and older, both incidence and death rates are increasing in the under-50 population. “We’re seeing a scary trend of younger patients getting colorectal cancer,” remarks Dr. Boccia, “even down into the 20s.” However, at this point in time, there’s insufficient data to clearly identify the causation behind this trend.

 

Colorectal Cancer Risk Factors

According to a report from the Maryland Department of Health and Mental Hygiene, the incidence rate of colon cancer per 100,000 people in Maryland was 1,174 for men and 1,109 for women in 2012. When looking at new cases of CRC, research shows that incidence may be tied to habits and lifestyles. Among these lifestyle- associated risk factors are being overweight or obese, lack of physical activity, smoking, heavy alcohol use and certain types of diets.

As outlined by the American Cancer Society, other risk factors unrelated to lifestyle choices are personal and family histories of colorectal cancer or adenomatous polyps, having type 2 diabetes, possessing an inherited syndrome, such as Lynch Syndrome, and certain racial and ethnic backgrounds. In addition, Dr. Boccia notes that a personal history of inflammatory bowel disease may increase the risk for developing colorectal cancer. “Patients with ulcerative colitis have to be screened very frequently for colon cancer,” Dr. Boccia elucidates, “because of that high predisposition.”

 

Common CRC Treatments

“For early stage colorectal cancer, the treatment of choice is surgery,” says Dr. Boccia. In this stage, a group of abnormal cells, referred to as carcinoma in situ (CIS), can be removed by a polypectomy, or a part of the colon can be removed via a partial colectomy. Once the cancer has penetrated the wall of the colon and perhaps even grown into nearby tissue, patients of RCCA Maryland will typically undergo active surveillance – although other treatment options are offered to those with high-risk tumors, says Dr. Boccia.

Once the cancer has reached Stage III, patients are generally offered a form of chemotherapy for roughly six weeks. “FOLFOX is the adjuvant therapy of choice,” says Dr. Boccia, “and that we know will lower the incidence of recurrence by about 40-50%.” For Stage IV diseases, which make up about 20% of the cases that RCCA Maryland sees each year, chemotherapy, targeted therapy and even immunotherapy can be used to offer aggressive treatment. If they no longer respond to a particular drug, patients will be introduced to a new regimen.

In regards to new research and treatment options, Dr. Boccia concludes, “I have 50 to 60 clinical trials open at all times in the center, so we’re always looking actively for good, cutting-edge therapies and offering those to our patients.”

 

If you or someone you love has been diagnosed with colorectal cancer, schedule an appointment at one of RCCA’s 29 locations in New Jersey, Maryland or Connecticut for personalized, professional care.

Molecular Testing: Tailoring Treatment by Targeting Pathways

Phillip D. Reid, MD

 

What is molecular testing? How it is used in cancer care?

A.  As we learn how to treat specific subtypes of cancer more accurately, molecular testing, molecular medicine and molecular diagnostics are becoming more prominent in oncology.

In the past, once a cancer was diagnosed, we determined the organ where it started, how much cancer was in the body and where it was. We have since discovered many pathways through which a cancer develops. We now need to know not only the stage, type and origin of cancer, but also the pathway through which it developed and then target that pathway.

 

How does the pathway concept affect therapy selection?

A.  It enhances our ability to treat the cancer, but we now need extra testing on a patient’s particular cancer cells. The great thing about molecular testing is we get an answer specific for the individual, not just for everyone, for example, with lung cancer. But it does require more time for us to find the pathway. From the patient’s standpoint, diagnosis and stage are obtained, and then sometimes we have to send off the cancer cells for extra testing, which increases the time between diagnosis and treatment. But ultimately, a better sense is provided of what drug to use and when to use it, and there’s a much greater likelihood of devising specific, effective treatment.

 

For which types of cancer should molecular testing be used?

A.  Molecular testing has revolutionized every major cancer diagnosis. Patients with lung and breast cancer are the best candidates, but molecular testing also is useful in colon cancer, head-and-neck and bladder cancer, and some leukemias and myelomas.

 

What have been the main developments over the last two to three years with molecular testing?

A.  It’s becoming easier and more standardized to get molecular testing done. A patient receives a diagnosis and his or her cancer is sent off to a lab, which evaluates all known pathways for that cancer. A specific result is received. As the patient receives therapy, sometimes the cancer changes and he or she may need a second or third biopsy one to three years after the initial diagnosis to see what’s changed in the cancer, and then the treatment changes based on that result. We now see cancer as a moving target as it progresses, and we have to recalibrate every few years so that we’re shooting that target correctly.

 

What should patients know about molecular testing before proceeding?

A.  After a patient receives his or her staging diagnosis, the next question is, “What subtype of lung cancer do I have and what pathway did the cancer use to develop?” The patient needs to have patience, as that extra information may not arrive for two to four weeks, but that information can increase the chances of treatment success.

Also ask about clinical trials of cancer medications before beginning therapy, because we often know about upcoming medications that are effective and possibly better than what we have right now.

Colorectal Cancer Trends and Treatment

Ralph V. Boccia, MD, a cancer specialist at RCCA Maryland, provides some insight into recent colorectal cancer trends and treatments that are giving new hope to doctors, researchers and patients nationwide. Overall, Dr. Boccia finds much to be encouraged by, but also points to the need for awareness of a concerning development in the field of colorectal cancer.

 

How Far We’ve Come and Where We’re Going

As a whole, colorectal cancer rates have been dropping. According to the National Cancer Institute and Centers for Disease Control and Prevention, Maryland alone has seen a 2.6% decrease in the amount of new CRC patients diagnosed over a five-year period. Dr. Boccia believes this trend can be partly attributed to the following:

  • Widespread increase in colonoscopies and other CRC screening methods
  • Early detection and removal of polyps before they become cancerous
  • More cases being diagnosed at an early stage – when the cancer is more responsive to treatment

Despite the good news, it’s still projected that 2,358 Maryland residents will be diagnosed and that 927 people will die from the disease this year, says Dr. Boccia. Doctors have also been noticing an uncharacteristic increase in the amount of younger adults being diagnosed with CRC. Since it typically affects individuals above the age of 50, this emerging demographic has been cause for concern. But Dr. Boccia and his colleagues will continue to conduct research and make further strides in colorectal cancer care to better serve patients of all ages.

 

Current Treatment Options

Surgical innovations, targeted therapies, immunotherapies, chemotherapy and clinical trials are paving the way for more effective CRC solutions. Dr. Boccia explains, “We have a greater ability than ever before to individualize care, and to offer patients multi-modal treatment regimens that employ a variety of mechanisms of action to combat cancer by different means.”

 

Reducing Your Risk

Follow these tips to help reduce your risk for developing colorectal cancer:

  • Maintain a healthy weight
  • Stay physically active
  • Avoid smoking cigarettes and only drink alcohol in moderation
  • Get a CRC screening regularly
  • Consult a physician right away if you experience any CRC symptoms, such as blood in the stool and persistent abdominal pain
  • Manage other conditions that may increase your risk for CRC, like type 2 diabetes, inflammatory bowel disease and adenomatous polyps

 

If you or someone you love has been diagnosed with colorectal cancer, schedule an appointment at one of RCCA’s 29 locations in New Jersey, Maryland or Connecticut for personalized, professional care.

RCCA Earns URAC Accreditation In Specialty Pharmacy

[Hackensack, NJ] – RCCA is proud to announce that it has earned URAC accreditation in Specialty Pharmacy. URAC is the independent leader in promoting healthcare quality through accreditation, certification and measurement. By achieving this status, RCCA has demonstrated a comprehensive commitment to quality care, improved processes and better patient outcomes.

 

“URAC Accreditation is a testament to the commitment of delivering the highest level of quality standards to our patients and their caregivers,” said Terrill Jordan, President and CEO of RCCA. ”This type of commitment is the cornerstone of everything we do at RCCA,” he added.

Edward Licitra, MD, PhD, RCCA Chairperson of the Board and RCCA Pharmacy Medical Director and Eileen Peng, PharmD, Director of the RCCA Pharmacy agree that “this new recognition will allow us to continue to provide the highest level of patient care and convenience for the people that need it the most.”

 

“Pharmacy services have never played such an important role in the delivery of care as they do today. RCCA distinguishes itself for having voluntarily undergone a rigorous review of quality standards that earned it URAC accreditation,” said URAC President and CEO Kylanne Green. “Independent URAC accreditation shows RCCA is dedicated to quality and safety, and that it strives for a continual improvement of its services.”

ABOUT RCCA

Regional Cancer Care Associates (RCCA), one of the largest oncology physician networks in the United States, is transforming oncology care by ensuring that cancer patients have access to the highest-quality, most-comprehensive, cutting edge treatments in a compassionate and community-based setting. RCCA includes more than 100 cancer care specialists and is supported by 800 employees at more than 30 care delivery sites, providing care to more than 24,000 new patients annually and over 240,000 existing patients.  For more information visit: http://www.RCCA.com

About URAC

Founded in 1990, URAC is the independent leader in promoting healthcare quality through accreditation, certification and measurement. URAC is a nonprofit organization developing evidence-based measures and standards through inclusive engagement with a range of stakeholders committed to improving the quality of healthcare. Our portfolio of accreditation and certification programs span the healthcare industry, addressing healthcare management, healthcare operations, health plans, pharmacies, telehealth providers, physician practices, and more. URAC accreditation is a symbol of excellence for organizations to showcase their validated commitment to quality and accountability.

For further information, contact:

Mary Lou Salvemini
msalvemini@regionalcancercare.org
(201) 510-0922

RCCA Makes Innovative UnitedHealthcare Cancer Care Program Available to Patients in Maryland

HACKENSACK, N.J., Nov. 22, 2016 /PRNewswire-USNewswire/ — Regional Cancer Care Associates (RCCA) is expanding its cancer care payment initiative with UnitedHealthcare to RCCA patients in Maryland who are covered by UnitedHealthcare benefit plans.

The program, made available at RCCA New Jersey locations in January, rewards physicians for focusing on best treatment practices, quality patient care and better health outcomes. The program pays participating medical oncologists more if they demonstrate superior clinical results and if they reduce the total cost of care.

The episode payment model shifts reimbursement away from the current “fee-for-service” approach that emphasizes volume of care delivered regardless of a patient’s health outcomes. The episode payment is based on the expected cost of a standard treatment regimen for a specific condition, as predetermined by the doctor. Similar payment models have been shown to enhance care coordination and improve health outcomes for patients, while reducing overall costs.

“RCCA has emerged as a leader in delivering the highest-level quality cancer care to our patients,” said Terrill Jordan, RCCA President and CEO. “New payment methodologies like this put patients’ interests at the forefront of cancer treatment. It also results in significant cost savings, which advances efforts across the country to assist in controlling rising health care costs. We are excited to offer this program to our Maryland patient base.”

Lee N. Newcomer, M.D., UnitedHealthcare’s Senior Vice President, Oncology, said: “Our partnership with RCCA marks an important step toward expanded episode payment models and away from the traditional fee-for-service payments for oncology care. We look forward to working with RCCA and others to expand our efforts to identify best practices for treating cancer.”

A study published in the Journal of Oncology Practice has demonstrated that this program reduced overall cancer expenses by more than a third while improving quality outcomes. RCCA is among five oncology practices that have joined the program, which now has a total of more than 650 oncologists. RCCA in New Jersey and now Maryland comprise approximately 100 of these oncologists.

“Value-based cancer care is here. This program will enable Maryland-based RCCA oncologists to continue to provide patient-centered care at the highest level of quality,” said Ralph Boccia, M.D., RCCA Research Deputy Chair and Oncologist in Bethesda and Germantown, Md.

UnitedHealthcare first implemented its episode payment program as a pilot study between October 2009 and December 2012. The pilot study produced a significant reduction in hospitalizations and a 34 percent reduction in total costs while improving quality. Click here to read results of the study.

About RCCA
Regional Cancer Care Associates (RCCA), one of the largest oncology physician networks in the United States, is transforming oncology care by ensuring that cancer patients have access to the highest-quality, most-comprehensive, cutting edge treatments in a compassionate and community-based setting. RCCA includes 100 cancer care specialists and is supported by 700 employees at 27 care delivery sites, providing care to more than 230,000 existing patients in New Jersey, Maryland and Washington DC.  For more information visit: http://www.RCCA.com

Contact:

Mary Lou Salvemini
msalvemini@regionalcancercare.org
(201) 510-0922

REGIONAL CANCER CARE ASSOCIATES AND AETNA FORM ONCOLOGY MEDICAL HOME

REGIONAL CANCER CARE ASSOCIATES AND AETNA FORM ONCOLOGY MEDICAL HOME

— The Patient-Focused Model Supports High-Value Care–

 

Hackensack, NJ, October 12, 2016 — Regional Cancer Care Associates (RCCA) and Aetna (NYSE: AET) announced a collaboration to create an oncology medical home that is designed to improve the care experience for cancer patients.

In the oncology medical home model, teams of cancer specialists collectively provide a patient’s health care when he or she has a cancer diagnosis. The model will give RCCA the responsibility to arrange appropriate care that is continuous and proactive and physicians will be incentivized for improved health, affordability and a better patient experience.

The oncology medical home arrangement will be available to patients at all RCCA locations in New Jersey and Maryland.

“RCCA is excited to partner with Aetna on this program. It aligns with our vision of providing patient centered care close to home,” said Terrill Jordan, RCCA President & CEO. “This partnership will not only enable us to continue the delivery of high quality care through reduced side effects, but will also facilitate cost effective care based on the data Aetna will be sharing,” said Michael Ruiz de Somocurcio, RCCA Vice President of Payer and Provider Collaboration.

The model is part of a strategic direction to transition from fee-for-service medicine to value-based payment. Value-based arrangements are emerging as a solution to address rising health care costs, clinical inefficiency, duplication of services, and access to care. In value-based models, doctors and hospitals are paid for helping to keep people healthy and for improving the health of those who have chronic conditions in an evidence-based, cost-effective way.

“We understand that cancer treatment can be the hardest experience that our members will ever have to go through,” said Daniel Knecht, M.D., M.B.A., Aetna’s Head of Strategy & Planning and Interim Head of Oncology Solutions. “This oncology medical home with RCCA will help provide our members with high-quality care and an optimal patient experience.”

The operating principles of the RCCA and Aetna oncology medical home include:

  • An orientation to the whole person. A personal physician from RCCA will be responsible for providing or arranging all of a patient’s health care needs with other qualified professionals. This includes care for all stages of treatment: preventive services, acute care, chronic care, palliative care and end-of-life care.
  • Evidence-based, personalized medical care. The RCCA team will focus on making treatment decisions based on current medical evidence for each unique disease presentation, patient-specific factors and patient choice using appropriate treatments to improve quality and outcomes.
  • Coordinated and integrated care. Care will be facilitated, across all elements of the health system, to enable Aetna members to get the appropriate care when and where it is needed and wanted, in a culturally and linguistically appropriate manner.
  • Quality and safety. Quality and safety will be a focus of care, including the use of evidence-based medicine, clinical decision support tools and accountability for continuous quality improvement.
  • Enhanced access to care. Care will be available through systems such as open scheduling, expanded hours and new options for communication between Aetna members, their personal physicians and hospital staff.

The oncology medical home arrangement launched in September 2016.

About RCCA

Regional Cancer Care Associates (RCCA), one of the largest oncology physician networks in the United States, is transforming oncology care by ensuring that cancer patients have access to the highest-quality, most-comprehensive, cutting edge treatments in a compassionate and community-based setting. RCCA includes 100 cancer care specialists and is supported by 700 employees at 27 care delivery sites, providing care to more than 23,000 new patients annually and over 230,000 existing patients in New Jersey, Maryland and Washington DC. For more information visit: http://www.RCCA.com.

About Aetna

Aetna is one of the nation’s leading diversified health care benefits companies, serving an estimated 46.3 million people with information and resources to help them make better informed decisions about their health care. Aetna offers a broad range of traditional, voluntary and consumer-directed health insurance products and related services, including medical, pharmacy, dental, behavioral health, group life and disability plans, and medical management capabilities, Medicaid health care management services, workers’ compensation administrative services and health information technology products and services. Aetna’s customers include employer groups, individuals, college students, part-time and hourly workers, health plans, health care providers, governmental units, government-sponsored plans, labor groups and expatriates. For more information, see www.aetna.com and learn about how Aetna is helping to build a healthier world. @AetnaNews

 

###

What Cancer Patients Need To Know About Clinical Trials: Insights From New Jersey Hematologist /Oncologist Seth Berk

Seth Howard Berk, MD, a hematologist and medical oncologist with RCCA, reveals four facts that he shares with his patients when they ask about clinical trials.

First, a drug has been thoroughly tested well before it reaches the clinical trial stage. Pre-clinical trial testing involves looking at a drug’s effects on animals as well as human cells. This stage usually takes years of development. Also, the clinical studies have to be designed and conducted in accordance with rigorous ethical and safety criteria.

He also imparts the importance of not thinking of clinical trials as a last resort in treatment. While trials are typically suited for situations in which traditional therapy methods are not working for a patient, there is more evidence emerging of late-stage trials benefitting the patient when used early in the diagnosis process.

A myth that Dr. Berk debunks is the use of a placebo in cancer treatment. Some cancer patients are resistant to clinical trials because they fear there will be a placebo and they will suffer as a result. He says this is misinformation or something assumed from a patient’s memory of high school or college science experiments. In clinical trials, one group will be administered the trial agent while the other continues to have traditional therapy. There are rarely ever patients receiving zero care.

Lastly, Dr. Berk addresses the importance of clinical trials for cancer patients in general. Because of willing patients participating in more and more trials, doctors and patients can share in a community of knowledge and understanding, and, one day, a cure.

To read more about clinical trials, turn to “What cancer patients need to know about clinical trials: Insights from New Jersey oncologist/hematologist Seth Berk.”

RCCA: Taking Cancer Care To A Higher Level In NJ And Beyond

Edward J. Licitra, MD, PhD, board certified in internal medicine, hematology and medical oncology and chairman of the board of directors of Regional Cancer Care Associates (RCCA), shares some of his thoughts on potential models for a health care delivery reform system. Oncologists at RCCA, totaling 100 physicians, learn from each other’s best practices with the patient’s interest at the forefront. Through RCCA, patients can receive care at home instead of visiting a hospital or clinic. They have set up 27 care delivery sites, providing care to more than 23,000 new patients annually and approximately 230,000 existing patients in New Jersey, Maryland and Washington, D.C.

Another example of a successful care reform case is the Oncology Care Model (OCM) created by Medicare under the Affordable Care Act (ACA). The model questions how to best develop an integrated style of cancer care. It focuses on developing a care model for the future, using data sharing and streamlining economics for patients as well as providers. By digitizing patients’ medical histories and sharing them through hospitals and clinics, this model focuses on simplifying the oncology care process.

Lastly, the OCM utilizes evidence-based-medicine (EBM) practices throughout the entire spectrum of care. EBM produces the best methods regardless of cost, while even reducing cost by eliminating wasteful spending. The OCM focuses on patient-focused, research based therapy tailored to the individual patient.

To learn more about this topic, read “RCCA: Taking cancer care to a higher level in NJ and beyond.”

Targeting Treatments for Chronic Lymphocytic Leukemia

Dr. Joel Silver

 

How do myeloma and chronic lymphocytic leukemia (CLL) develop? What are some risk factors associated with those malignancies?

A. We don’t know what causes CLL. We do know that people in some occupations or with a certain exposure history might be at higher risk, and that CLL generally affects older people. Treatment fortunately is not needed in many cases, but even so our treatment options have evolved based on cytogenetics and next-generation sequencing. We have more ways to assess prognostic features and design more personalized and potentially more effective therapy for people with CLL.

 

What therapies have been successful in treating CLL over the last two to three years?

A. If you can identify a certain kind of CLL, such as IDH-mutated CLL, some of the patients with it can receive a standard chemotherapy regimen called FCR, and they sometimes go into remission indefinitely. It depends on whether the patient is young and healthy enough to tolerate the therapy. That’s a select group, though; you don’t see too many young people with CLL.

Years ago, an effective treatment did not exist for another group of patients with CLL, those with the genetic 17p deletion. In recent years, however, the oral agent ibrutinib has shown effectiveness for CLL in this group. Other therapies now are available for patients who don’t respond to ibrutinib.

 

Where does targeted therapy come into play?

A. In general, “targeted therapy” refers to a treatment based on a particular mutation or pattern. The presence of the genetic 17p deletion in CLL is one example, but this is a bad cytogenetic abnormality for which standard treatments such as chemotherapy haven’t worked. If we can identify a particular mutation, then we can target our therapy and plan treatment that we know will work, instead of going through chemotherapies that are only partially effective or downright ineffective and then finding that the patient is resistant to treatment.

 

Are there side effects or drawbacks to targeted therapy?

A. Everything we do has side effects. The oral agent ibrutinib has been an effective first-line therapy for any type of CLL. Although the agent is specifically for patients with 17p deletion, it has also worked for patients without that genetic feature. While some cardiovascular and bleeding issues have been reported, ibrutinib overall is more tolerable than chemotherapy.

When we medically examine patients with CLL, we always look at a pattern of mutations to try to identify how to treat these people — not so much from an immediate therapeutic standpoint, but to gain knowledge of all these other cytogenetic abnormalities so that eventually, we will find other ways to target those different patterns.

What important points do you address with patients before they begin CLL therapy?

A. Many people with CLL don’t die of their disease, they die with their disease, so I tell patients not to be afraid of the disease itself. Many of the conversations we have with these people, however, revolve around the fact that they have this problem but may never need treatment. “We should follow you because you may need treatment down the line,” I tell them. “If you need treatment, we have many effective therapies.”

 

Do you foresee different therapies for CLL emerging within the next two to three years?

A. A number of medications are on the horizon that will be appropriate for any patient with CLL. For example, venetoclax, which gained FDA approval last year, is indicated for second-line treatment of CLL in patients with the 17p deletion, but I think that agent will be effective for all patients with CLL. As similarly versatile agents are developed, we will have many more treatment options.

Colorectal Cancer Trends in Maryland: A Conversation with Dr. Ralph V. Boccia

As the third most common cancer in the United States, colorectal cancer (CRC) affects about 1 in 20 Americans. However, incidence and death rates for cancer of the colorectum have significantly decreased over the past several decades as a result of increased screening and drastic improvements in treatment. In Maryland alone, approximately 70% of adults over the age of 50 have an up-to-date colorectal cancer screening, helping contribute to the reduction in mortality rates.

Dr. Ralph V. Boccia, an oncology and hematology specialist at Regional Cancer Care Associates (RCCA) in Bethesda and Germantown, Maryland says, “The more colorectal screening we have and the earlier it gets started, the lower the stage that the cancer is typically picked up.” In turn, early detection has led to the state’s lower mortality rates over time.

 

The Benefits Of Increased Screening

According to Dr. Boccia, improving screening rates “affects the stage at which the cancer presents itself and [the patient’s] potential for survival.” Between 2002 and 2010, the percentage of Maryland adults with up-to-date colorectal cancer screenings increased from 64% to 71%. As a result, CRC mortality rates in Maryland decreased considerably among both men and women in that eight-year timeframe. Dr. Boccia explains, “The trend we’ve actually seen – which is that more people are being screened – has resulted in more improvements of overall survival in patients with colorectal cancer.”

However, as colon cancer rates decline in adults 50 years and older, both incidence and death rates are increasing in the under-50 population. “We’re seeing a scary trend of younger patients getting colorectal cancer,” remarks Dr. Boccia, “even down into the 20s.” However, at this point in time, there’s insufficient data to clearly identify the causation behind this trend.

 

Colorectal Cancer Risk Factors

According to a report from the Maryland Department of Health and Mental Hygiene, the incidence rate of colon cancer per 100,000 people in Maryland was 1,174 for men and 1,109 for women in 2012. When looking at new cases of CRC, research shows that incidence may be tied to habits and lifestyles. Among these lifestyle- associated risk factors are being overweight or obese, lack of physical activity, smoking, heavy alcohol use and certain types of diets.

As outlined by the American Cancer Society, other risk factors unrelated to lifestyle choices are personal and family histories of colorectal cancer or adenomatous polyps, having type 2 diabetes, possessing an inherited syndrome, such as Lynch Syndrome, and certain racial and ethnic backgrounds. In addition, Dr. Boccia notes that a personal history of inflammatory bowel disease may increase the risk for developing colorectal cancer. “Patients with ulcerative colitis have to be screened very frequently for colon cancer,” Dr. Boccia elucidates, “because of that high predisposition.”

 

Common CRC Treatments

“For early stage colorectal cancer, the treatment of choice is surgery,” says Dr. Boccia. In this stage, a group of abnormal cells, referred to as carcinoma in situ (CIS), can be removed by a polypectomy, or a part of the colon can be removed via a partial colectomy. Once the cancer has penetrated the wall of the colon and perhaps even grown into nearby tissue, patients of RCCA Maryland will typically undergo active surveillance – although other treatment options are offered to those with high-risk tumors, says Dr. Boccia.

Once the cancer has reached Stage III, patients are generally offered a form of chemotherapy for roughly six weeks. “FOLFOX is the adjuvant therapy of choice,” says Dr. Boccia, “and that we know will lower the incidence of recurrence by about 40-50%.” For Stage IV diseases, which make up about 20% of the cases that RCCA Maryland sees each year, chemotherapy, targeted therapy and even immunotherapy can be used to offer aggressive treatment. If they no longer respond to a particular drug, patients will be introduced to a new regimen.

In regards to new research and treatment options, Dr. Boccia concludes, “I have 50 to 60 clinical trials open at all times in the center, so we’re always looking actively for good, cutting-edge therapies and offering those to our patients.”

 

If you or someone you love has been diagnosed with colorectal cancer, schedule an appointment at one of RCCA’s 29 locations in New Jersey, Maryland or Connecticut for personalized, professional care.

Molecular Testing: Tailoring Treatment by Targeting Pathways

Phillip D. Reid, MD

 

What is molecular testing? How it is used in cancer care?

A.  As we learn how to treat specific subtypes of cancer more accurately, molecular testing, molecular medicine and molecular diagnostics are becoming more prominent in oncology.

In the past, once a cancer was diagnosed, we determined the organ where it started, how much cancer was in the body and where it was. We have since discovered many pathways through which a cancer develops. We now need to know not only the stage, type and origin of cancer, but also the pathway through which it developed and then target that pathway.

 

How does the pathway concept affect therapy selection?

A.  It enhances our ability to treat the cancer, but we now need extra testing on a patient’s particular cancer cells. The great thing about molecular testing is we get an answer specific for the individual, not just for everyone, for example, with lung cancer. But it does require more time for us to find the pathway. From the patient’s standpoint, diagnosis and stage are obtained, and then sometimes we have to send off the cancer cells for extra testing, which increases the time between diagnosis and treatment. But ultimately, a better sense is provided of what drug to use and when to use it, and there’s a much greater likelihood of devising specific, effective treatment.

 

For which types of cancer should molecular testing be used?

A.  Molecular testing has revolutionized every major cancer diagnosis. Patients with lung and breast cancer are the best candidates, but molecular testing also is useful in colon cancer, head-and-neck and bladder cancer, and some leukemias and myelomas.

 

What have been the main developments over the last two to three years with molecular testing?

A.  It’s becoming easier and more standardized to get molecular testing done. A patient receives a diagnosis and his or her cancer is sent off to a lab, which evaluates all known pathways for that cancer. A specific result is received. As the patient receives therapy, sometimes the cancer changes and he or she may need a second or third biopsy one to three years after the initial diagnosis to see what’s changed in the cancer, and then the treatment changes based on that result. We now see cancer as a moving target as it progresses, and we have to recalibrate every few years so that we’re shooting that target correctly.

 

What should patients know about molecular testing before proceeding?

A.  After a patient receives his or her staging diagnosis, the next question is, “What subtype of lung cancer do I have and what pathway did the cancer use to develop?” The patient needs to have patience, as that extra information may not arrive for two to four weeks, but that information can increase the chances of treatment success.

Also ask about clinical trials of cancer medications before beginning therapy, because we often know about upcoming medications that are effective and possibly better than what we have right now.

Colorectal Cancer Trends and Treatment

Ralph V. Boccia, MD, a cancer specialist at RCCA Maryland, provides some insight into recent colorectal cancer trends and treatments that are giving new hope to doctors, researchers and patients nationwide. Overall, Dr. Boccia finds much to be encouraged by, but also points to the need for awareness of a concerning development in the field of colorectal cancer.

 

How Far We’ve Come and Where We’re Going

As a whole, colorectal cancer rates have been dropping. According to the National Cancer Institute and Centers for Disease Control and Prevention, Maryland alone has seen a 2.6% decrease in the amount of new CRC patients diagnosed over a five-year period. Dr. Boccia believes this trend can be partly attributed to the following:

  • Widespread increase in colonoscopies and other CRC screening methods
  • Early detection and removal of polyps before they become cancerous
  • More cases being diagnosed at an early stage – when the cancer is more responsive to treatment

Despite the good news, it’s still projected that 2,358 Maryland residents will be diagnosed and that 927 people will die from the disease this year, says Dr. Boccia. Doctors have also been noticing an uncharacteristic increase in the amount of younger adults being diagnosed with CRC. Since it typically affects individuals above the age of 50, this emerging demographic has been cause for concern. But Dr. Boccia and his colleagues will continue to conduct research and make further strides in colorectal cancer care to better serve patients of all ages.

 

Current Treatment Options

Surgical innovations, targeted therapies, immunotherapies, chemotherapy and clinical trials are paving the way for more effective CRC solutions. Dr. Boccia explains, “We have a greater ability than ever before to individualize care, and to offer patients multi-modal treatment regimens that employ a variety of mechanisms of action to combat cancer by different means.”

 

Reducing Your Risk

Follow these tips to help reduce your risk for developing colorectal cancer:

  • Maintain a healthy weight
  • Stay physically active
  • Avoid smoking cigarettes and only drink alcohol in moderation
  • Get a CRC screening regularly
  • Consult a physician right away if you experience any CRC symptoms, such as blood in the stool and persistent abdominal pain
  • Manage other conditions that may increase your risk for CRC, like type 2 diabetes, inflammatory bowel disease and adenomatous polyps

 

If you or someone you love has been diagnosed with colorectal cancer, schedule an appointment at one of RCCA’s 29 locations in New Jersey, Maryland or Connecticut for personalized, professional care.

RCCA Earns URAC Accreditation In Specialty Pharmacy

[Hackensack, NJ] – RCCA is proud to announce that it has earned URAC accreditation in Specialty Pharmacy. URAC is the independent leader in promoting healthcare quality through accreditation, certification and measurement. By achieving this status, RCCA has demonstrated a comprehensive commitment to quality care, improved processes and better patient outcomes.

 

“URAC Accreditation is a testament to the commitment of delivering the highest level of quality standards to our patients and their caregivers,” said Terrill Jordan, President and CEO of RCCA. ”This type of commitment is the cornerstone of everything we do at RCCA,” he added.

Edward Licitra, MD, PhD, RCCA Chairperson of the Board and RCCA Pharmacy Medical Director and Eileen Peng, PharmD, Director of the RCCA Pharmacy agree that “this new recognition will allow us to continue to provide the highest level of patient care and convenience for the people that need it the most.”

 

“Pharmacy services have never played such an important role in the delivery of care as they do today. RCCA distinguishes itself for having voluntarily undergone a rigorous review of quality standards that earned it URAC accreditation,” said URAC President and CEO Kylanne Green. “Independent URAC accreditation shows RCCA is dedicated to quality and safety, and that it strives for a continual improvement of its services.”

ABOUT RCCA

Regional Cancer Care Associates (RCCA), one of the largest oncology physician networks in the United States, is transforming oncology care by ensuring that cancer patients have access to the highest-quality, most-comprehensive, cutting edge treatments in a compassionate and community-based setting. RCCA includes more than 100 cancer care specialists and is supported by 800 employees at more than 30 care delivery sites, providing care to more than 24,000 new patients annually and over 240,000 existing patients.  For more information visit: http://www.RCCA.com

About URAC

Founded in 1990, URAC is the independent leader in promoting healthcare quality through accreditation, certification and measurement. URAC is a nonprofit organization developing evidence-based measures and standards through inclusive engagement with a range of stakeholders committed to improving the quality of healthcare. Our portfolio of accreditation and certification programs span the healthcare industry, addressing healthcare management, healthcare operations, health plans, pharmacies, telehealth providers, physician practices, and more. URAC accreditation is a symbol of excellence for organizations to showcase their validated commitment to quality and accountability.

For further information, contact:

Mary Lou Salvemini
msalvemini@regionalcancercare.org
(201) 510-0922

RCCA Makes Innovative UnitedHealthcare Cancer Care Program Available to Patients in Maryland

HACKENSACK, N.J., Nov. 22, 2016 /PRNewswire-USNewswire/ — Regional Cancer Care Associates (RCCA) is expanding its cancer care payment initiative with UnitedHealthcare to RCCA patients in Maryland who are covered by UnitedHealthcare benefit plans.

The program, made available at RCCA New Jersey locations in January, rewards physicians for focusing on best treatment practices, quality patient care and better health outcomes. The program pays participating medical oncologists more if they demonstrate superior clinical results and if they reduce the total cost of care.

The episode payment model shifts reimbursement away from the current “fee-for-service” approach that emphasizes volume of care delivered regardless of a patient’s health outcomes. The episode payment is based on the expected cost of a standard treatment regimen for a specific condition, as predetermined by the doctor. Similar payment models have been shown to enhance care coordination and improve health outcomes for patients, while reducing overall costs.

“RCCA has emerged as a leader in delivering the highest-level quality cancer care to our patients,” said Terrill Jordan, RCCA President and CEO. “New payment methodologies like this put patients’ interests at the forefront of cancer treatment. It also results in significant cost savings, which advances efforts across the country to assist in controlling rising health care costs. We are excited to offer this program to our Maryland patient base.”

Lee N. Newcomer, M.D., UnitedHealthcare’s Senior Vice President, Oncology, said: “Our partnership with RCCA marks an important step toward expanded episode payment models and away from the traditional fee-for-service payments for oncology care. We look forward to working with RCCA and others to expand our efforts to identify best practices for treating cancer.”

A study published in the Journal of Oncology Practice has demonstrated that this program reduced overall cancer expenses by more than a third while improving quality outcomes. RCCA is among five oncology practices that have joined the program, which now has a total of more than 650 oncologists. RCCA in New Jersey and now Maryland comprise approximately 100 of these oncologists.

“Value-based cancer care is here. This program will enable Maryland-based RCCA oncologists to continue to provide patient-centered care at the highest level of quality,” said Ralph Boccia, M.D., RCCA Research Deputy Chair and Oncologist in Bethesda and Germantown, Md.

UnitedHealthcare first implemented its episode payment program as a pilot study between October 2009 and December 2012. The pilot study produced a significant reduction in hospitalizations and a 34 percent reduction in total costs while improving quality. Click here to read results of the study.

About RCCA
Regional Cancer Care Associates (RCCA), one of the largest oncology physician networks in the United States, is transforming oncology care by ensuring that cancer patients have access to the highest-quality, most-comprehensive, cutting edge treatments in a compassionate and community-based setting. RCCA includes 100 cancer care specialists and is supported by 700 employees at 27 care delivery sites, providing care to more than 230,000 existing patients in New Jersey, Maryland and Washington DC.  For more information visit: http://www.RCCA.com

Contact:

Mary Lou Salvemini
msalvemini@regionalcancercare.org
(201) 510-0922

REGIONAL CANCER CARE ASSOCIATES AND AETNA FORM ONCOLOGY MEDICAL HOME

REGIONAL CANCER CARE ASSOCIATES AND AETNA FORM ONCOLOGY MEDICAL HOME

— The Patient-Focused Model Supports High-Value Care–

 

Hackensack, NJ, October 12, 2016 — Regional Cancer Care Associates (RCCA) and Aetna (NYSE: AET) announced a collaboration to create an oncology medical home that is designed to improve the care experience for cancer patients.

In the oncology medical home model, teams of cancer specialists collectively provide a patient’s health care when he or she has a cancer diagnosis. The model will give RCCA the responsibility to arrange appropriate care that is continuous and proactive and physicians will be incentivized for improved health, affordability and a better patient experience.

The oncology medical home arrangement will be available to patients at all RCCA locations in New Jersey and Maryland.

“RCCA is excited to partner with Aetna on this program. It aligns with our vision of providing patient centered care close to home,” said Terrill Jordan, RCCA President & CEO. “This partnership will not only enable us to continue the delivery of high quality care through reduced side effects, but will also facilitate cost effective care based on the data Aetna will be sharing,” said Michael Ruiz de Somocurcio, RCCA Vice President of Payer and Provider Collaboration.

The model is part of a strategic direction to transition from fee-for-service medicine to value-based payment. Value-based arrangements are emerging as a solution to address rising health care costs, clinical inefficiency, duplication of services, and access to care. In value-based models, doctors and hospitals are paid for helping to keep people healthy and for improving the health of those who have chronic conditions in an evidence-based, cost-effective way.

“We understand that cancer treatment can be the hardest experience that our members will ever have to go through,” said Daniel Knecht, M.D., M.B.A., Aetna’s Head of Strategy & Planning and Interim Head of Oncology Solutions. “This oncology medical home with RCCA will help provide our members with high-quality care and an optimal patient experience.”

The operating principles of the RCCA and Aetna oncology medical home include:

  • An orientation to the whole person. A personal physician from RCCA will be responsible for providing or arranging all of a patient’s health care needs with other qualified professionals. This includes care for all stages of treatment: preventive services, acute care, chronic care, palliative care and end-of-life care.
  • Evidence-based, personalized medical care. The RCCA team will focus on making treatment decisions based on current medical evidence for each unique disease presentation, patient-specific factors and patient choice using appropriate treatments to improve quality and outcomes.
  • Coordinated and integrated care. Care will be facilitated, across all elements of the health system, to enable Aetna members to get the appropriate care when and where it is needed and wanted, in a culturally and linguistically appropriate manner.
  • Quality and safety. Quality and safety will be a focus of care, including the use of evidence-based medicine, clinical decision support tools and accountability for continuous quality improvement.
  • Enhanced access to care. Care will be available through systems such as open scheduling, expanded hours and new options for communication between Aetna members, their personal physicians and hospital staff.

The oncology medical home arrangement launched in September 2016.

About RCCA

Regional Cancer Care Associates (RCCA), one of the largest oncology physician networks in the United States, is transforming oncology care by ensuring that cancer patients have access to the highest-quality, most-comprehensive, cutting edge treatments in a compassionate and community-based setting. RCCA includes 100 cancer care specialists and is supported by 700 employees at 27 care delivery sites, providing care to more than 23,000 new patients annually and over 230,000 existing patients in New Jersey, Maryland and Washington DC. For more information visit: http://www.RCCA.com.

About Aetna

Aetna is one of the nation’s leading diversified health care benefits companies, serving an estimated 46.3 million people with information and resources to help them make better informed decisions about their health care. Aetna offers a broad range of traditional, voluntary and consumer-directed health insurance products and related services, including medical, pharmacy, dental, behavioral health, group life and disability plans, and medical management capabilities, Medicaid health care management services, workers’ compensation administrative services and health information technology products and services. Aetna’s customers include employer groups, individuals, college students, part-time and hourly workers, health plans, health care providers, governmental units, government-sponsored plans, labor groups and expatriates. For more information, see www.aetna.com and learn about how Aetna is helping to build a healthier world. @AetnaNews

 

###

What Cancer Patients Need To Know About Clinical Trials: Insights From New Jersey Hematologist /Oncologist Seth Berk

Seth Howard Berk, MD, a hematologist and medical oncologist with RCCA, reveals four facts that he shares with his patients when they ask about clinical trials.

First, a drug has been thoroughly tested well before it reaches the clinical trial stage. Pre-clinical trial testing involves looking at a drug’s effects on animals as well as human cells. This stage usually takes years of development. Also, the clinical studies have to be designed and conducted in accordance with rigorous ethical and safety criteria.

He also imparts the importance of not thinking of clinical trials as a last resort in treatment. While trials are typically suited for situations in which traditional therapy methods are not working for a patient, there is more evidence emerging of late-stage trials benefitting the patient when used early in the diagnosis process.

A myth that Dr. Berk debunks is the use of a placebo in cancer treatment. Some cancer patients are resistant to clinical trials because they fear there will be a placebo and they will suffer as a result. He says this is misinformation or something assumed from a patient’s memory of high school or college science experiments. In clinical trials, one group will be administered the trial agent while the other continues to have traditional therapy. There are rarely ever patients receiving zero care.

Lastly, Dr. Berk addresses the importance of clinical trials for cancer patients in general. Because of willing patients participating in more and more trials, doctors and patients can share in a community of knowledge and understanding, and, one day, a cure.

To read more about clinical trials, turn to “What cancer patients need to know about clinical trials: Insights from New Jersey oncologist/hematologist Seth Berk.”

RCCA: Taking Cancer Care To A Higher Level In NJ And Beyond

Edward J. Licitra, MD, PhD, board certified in internal medicine, hematology and medical oncology and chairman of the board of directors of Regional Cancer Care Associates (RCCA), shares some of his thoughts on potential models for a health care delivery reform system. Oncologists at RCCA, totaling 100 physicians, learn from each other’s best practices with the patient’s interest at the forefront. Through RCCA, patients can receive care at home instead of visiting a hospital or clinic. They have set up 27 care delivery sites, providing care to more than 23,000 new patients annually and approximately 230,000 existing patients in New Jersey, Maryland and Washington, D.C.

Another example of a successful care reform case is the Oncology Care Model (OCM) created by Medicare under the Affordable Care Act (ACA). The model questions how to best develop an integrated style of cancer care. It focuses on developing a care model for the future, using data sharing and streamlining economics for patients as well as providers. By digitizing patients’ medical histories and sharing them through hospitals and clinics, this model focuses on simplifying the oncology care process.

Lastly, the OCM utilizes evidence-based-medicine (EBM) practices throughout the entire spectrum of care. EBM produces the best methods regardless of cost, while even reducing cost by eliminating wasteful spending. The OCM focuses on patient-focused, research based therapy tailored to the individual patient.

To learn more about this topic, read “RCCA: Taking cancer care to a higher level in NJ and beyond.”

Targeting Treatments for Chronic Lymphocytic Leukemia

Dr. Joel Silver

 

How do myeloma and chronic lymphocytic leukemia (CLL) develop? What are some risk factors associated with those malignancies?

A. We don’t know what causes CLL. We do know that people in some occupations or with a certain exposure history might be at higher risk, and that CLL generally affects older people. Treatment fortunately is not needed in many cases, but even so our treatment options have evolved based on cytogenetics and next-generation sequencing. We have more ways to assess prognostic features and design more personalized and potentially more effective therapy for people with CLL.

 

What therapies have been successful in treating CLL over the last two to three years?

A. If you can identify a certain kind of CLL, such as IDH-mutated CLL, some of the patients with it can receive a standard chemotherapy regimen called FCR, and they sometimes go into remission indefinitely. It depends on whether the patient is young and healthy enough to tolerate the therapy. That’s a select group, though; you don’t see too many young people with CLL.

Years ago, an effective treatment did not exist for another group of patients with CLL, those with the genetic 17p deletion. In recent years, however, the oral agent ibrutinib has shown effectiveness for CLL in this group. Other therapies now are available for patients who don’t respond to ibrutinib.

 

Where does targeted therapy come into play?

A. In general, “targeted therapy” refers to a treatment based on a particular mutation or pattern. The presence of the genetic 17p deletion in CLL is one example, but this is a bad cytogenetic abnormality for which standard treatments such as chemotherapy haven’t worked. If we can identify a particular mutation, then we can target our therapy and plan treatment that we know will work, instead of going through chemotherapies that are only partially effective or downright ineffective and then finding that the patient is resistant to treatment.

 

Are there side effects or drawbacks to targeted therapy?

A. Everything we do has side effects. The oral agent ibrutinib has been an effective first-line therapy for any type of CLL. Although the agent is specifically for patients with 17p deletion, it has also worked for patients without that genetic feature. While some cardiovascular and bleeding issues have been reported, ibrutinib overall is more tolerable than chemotherapy.

When we medically examine patients with CLL, we always look at a pattern of mutations to try to identify how to treat these people — not so much from an immediate therapeutic standpoint, but to gain knowledge of all these other cytogenetic abnormalities so that eventually, we will find other ways to target those different patterns.

What important points do you address with patients before they begin CLL therapy?

A. Many people with CLL don’t die of their disease, they die with their disease, so I tell patients not to be afraid of the disease itself. Many of the conversations we have with these people, however, revolve around the fact that they have this problem but may never need treatment. “We should follow you because you may need treatment down the line,” I tell them. “If you need treatment, we have many effective therapies.”

 

Do you foresee different therapies for CLL emerging within the next two to three years?

A. A number of medications are on the horizon that will be appropriate for any patient with CLL. For example, venetoclax, which gained FDA approval last year, is indicated for second-line treatment of CLL in patients with the 17p deletion, but I think that agent will be effective for all patients with CLL. As similarly versatile agents are developed, we will have many more treatment options.

Colorectal Cancer Trends in Maryland: A Conversation with Dr. Ralph V. Boccia

As the third most common cancer in the United States, colorectal cancer (CRC) affects about 1 in 20 Americans. However, incidence and death rates for cancer of the colorectum have significantly decreased over the past several decades as a result of increased screening and drastic improvements in treatment. In Maryland alone, approximately 70% of adults over the age of 50 have an up-to-date colorectal cancer screening, helping contribute to the reduction in mortality rates.

Dr. Ralph V. Boccia, an oncology and hematology specialist at Regional Cancer Care Associates (RCCA) in Bethesda and Germantown, Maryland says, “The more colorectal screening we have and the earlier it gets started, the lower the stage that the cancer is typically picked up.” In turn, early detection has led to the state’s lower mortality rates over time.

 

The Benefits Of Increased Screening

According to Dr. Boccia, improving screening rates “affects the stage at which the cancer presents itself and [the patient’s] potential for survival.” Between 2002 and 2010, the percentage of Maryland adults with up-to-date colorectal cancer screenings increased from 64% to 71%. As a result, CRC mortality rates in Maryland decreased considerably among both men and women in that eight-year timeframe. Dr. Boccia explains, “The trend we’ve actually seen – which is that more people are being screened – has resulted in more improvements of overall survival in patients with colorectal cancer.”

However, as colon cancer rates decline in adults 50 years and older, both incidence and death rates are increasing in the under-50 population. “We’re seeing a scary trend of younger patients getting colorectal cancer,” remarks Dr. Boccia, “even down into the 20s.” However, at this point in time, there’s insufficient data to clearly identify the causation behind this trend.

 

Colorectal Cancer Risk Factors

According to a report from the Maryland Department of Health and Mental Hygiene, the incidence rate of colon cancer per 100,000 people in Maryland was 1,174 for men and 1,109 for women in 2012. When looking at new cases of CRC, research shows that incidence may be tied to habits and lifestyles. Among these lifestyle- associated risk factors are being overweight or obese, lack of physical activity, smoking, heavy alcohol use and certain types of diets.

As outlined by the American Cancer Society, other risk factors unrelated to lifestyle choices are personal and family histories of colorectal cancer or adenomatous polyps, having type 2 diabetes, possessing an inherited syndrome, such as Lynch Syndrome, and certain racial and ethnic backgrounds. In addition, Dr. Boccia notes that a personal history of inflammatory bowel disease may increase the risk for developing colorectal cancer. “Patients with ulcerative colitis have to be screened very frequently for colon cancer,” Dr. Boccia elucidates, “because of that high predisposition.”

 

Common CRC Treatments

“For early stage colorectal cancer, the treatment of choice is surgery,” says Dr. Boccia. In this stage, a group of abnormal cells, referred to as carcinoma in situ (CIS), can be removed by a polypectomy, or a part of the colon can be removed via a partial colectomy. Once the cancer has penetrated the wall of the colon and perhaps even grown into nearby tissue, patients of RCCA Maryland will typically undergo active surveillance – although other treatment options are offered to those with high-risk tumors, says Dr. Boccia.

Once the cancer has reached Stage III, patients are generally offered a form of chemotherapy for roughly six weeks. “FOLFOX is the adjuvant therapy of choice,” says Dr. Boccia, “and that we know will lower the incidence of recurrence by about 40-50%.” For Stage IV diseases, which make up about 20% of the cases that RCCA Maryland sees each year, chemotherapy, targeted therapy and even immunotherapy can be used to offer aggressive treatment. If they no longer respond to a particular drug, patients will be introduced to a new regimen.

In regards to new research and treatment options, Dr. Boccia concludes, “I have 50 to 60 clinical trials open at all times in the center, so we’re always looking actively for good, cutting-edge therapies and offering those to our patients.”

 

If you or someone you love has been diagnosed with colorectal cancer, schedule an appointment at one of RCCA’s 29 locations in New Jersey, Maryland or Connecticut for personalized, professional care.

Molecular Testing: Tailoring Treatment by Targeting Pathways

Phillip D. Reid, MD

 

What is molecular testing? How it is used in cancer care?

A.  As we learn how to treat specific subtypes of cancer more accurately, molecular testing, molecular medicine and molecular diagnostics are becoming more prominent in oncology.

In the past, once a cancer was diagnosed, we determined the organ where it started, how much cancer was in the body and where it was. We have since discovered many pathways through which a cancer develops. We now need to know not only the stage, type and origin of cancer, but also the pathway through which it developed and then target that pathway.

 

How does the pathway concept affect therapy selection?

A.  It enhances our ability to treat the cancer, but we now need extra testing on a patient’s particular cancer cells. The great thing about molecular testing is we get an answer specific for the individual, not just for everyone, for example, with lung cancer. But it does require more time for us to find the pathway. From the patient’s standpoint, diagnosis and stage are obtained, and then sometimes we have to send off the cancer cells for extra testing, which increases the time between diagnosis and treatment. But ultimately, a better sense is provided of what drug to use and when to use it, and there’s a much greater likelihood of devising specific, effective treatment.

 

For which types of cancer should molecular testing be used?

A.  Molecular testing has revolutionized every major cancer diagnosis. Patients with lung and breast cancer are the best candidates, but molecular testing also is useful in colon cancer, head-and-neck and bladder cancer, and some leukemias and myelomas.

 

What have been the main developments over the last two to three years with molecular testing?

A.  It’s becoming easier and more standardized to get molecular testing done. A patient receives a diagnosis and his or her cancer is sent off to a lab, which evaluates all known pathways for that cancer. A specific result is received. As the patient receives therapy, sometimes the cancer changes and he or she may need a second or third biopsy one to three years after the initial diagnosis to see what’s changed in the cancer, and then the treatment changes based on that result. We now see cancer as a moving target as it progresses, and we have to recalibrate every few years so that we’re shooting that target correctly.

 

What should patients know about molecular testing before proceeding?

A.  After a patient receives his or her staging diagnosis, the next question is, “What subtype of lung cancer do I have and what pathway did the cancer use to develop?” The patient needs to have patience, as that extra information may not arrive for two to four weeks, but that information can increase the chances of treatment success.

Also ask about clinical trials of cancer medications before beginning therapy, because we often know about upcoming medications that are effective and possibly better than what we have right now.

Colorectal Cancer Trends and Treatment

Ralph V. Boccia, MD, a cancer specialist at RCCA Maryland, provides some insight into recent colorectal cancer trends and treatments that are giving new hope to doctors, researchers and patients nationwide. Overall, Dr. Boccia finds much to be encouraged by, but also points to the need for awareness of a concerning development in the field of colorectal cancer.

 

How Far We’ve Come and Where We’re Going

As a whole, colorectal cancer rates have been dropping. According to the National Cancer Institute and Centers for Disease Control and Prevention, Maryland alone has seen a 2.6% decrease in the amount of new CRC patients diagnosed over a five-year period. Dr. Boccia believes this trend can be partly attributed to the following:

  • Widespread increase in colonoscopies and other CRC screening methods
  • Early detection and removal of polyps before they become cancerous
  • More cases being diagnosed at an early stage – when the cancer is more responsive to treatment

Despite the good news, it’s still projected that 2,358 Maryland residents will be diagnosed and that 927 people will die from the disease this year, says Dr. Boccia. Doctors have also been noticing an uncharacteristic increase in the amount of younger adults being diagnosed with CRC. Since it typically affects individuals above the age of 50, this emerging demographic has been cause for concern. But Dr. Boccia and his colleagues will continue to conduct research and make further strides in colorectal cancer care to better serve patients of all ages.

 

Current Treatment Options

Surgical innovations, targeted therapies, immunotherapies, chemotherapy and clinical trials are paving the way for more effective CRC solutions. Dr. Boccia explains, “We have a greater ability than ever before to individualize care, and to offer patients multi-modal treatment regimens that employ a variety of mechanisms of action to combat cancer by different means.”

 

Reducing Your Risk

Follow these tips to help reduce your risk for developing colorectal cancer:

  • Maintain a healthy weight
  • Stay physically active
  • Avoid smoking cigarettes and only drink alcohol in moderation
  • Get a CRC screening regularly
  • Consult a physician right away if you experience any CRC symptoms, such as blood in the stool and persistent abdominal pain
  • Manage other conditions that may increase your risk for CRC, like type 2 diabetes, inflammatory bowel disease and adenomatous polyps

 

If you or someone you love has been diagnosed with colorectal cancer, schedule an appointment at one of RCCA’s 29 locations in New Jersey, Maryland or Connecticut for personalized, professional care.

RCCA Earns URAC Accreditation In Specialty Pharmacy

[Hackensack, NJ] – RCCA is proud to announce that it has earned URAC accreditation in Specialty Pharmacy. URAC is the independent leader in promoting healthcare quality through accreditation, certification and measurement. By achieving this status, RCCA has demonstrated a comprehensive commitment to quality care, improved processes and better patient outcomes.

 

“URAC Accreditation is a testament to the commitment of delivering the highest level of quality standards to our patients and their caregivers,” said Terrill Jordan, President and CEO of RCCA. ”This type of commitment is the cornerstone of everything we do at RCCA,” he added.

Edward Licitra, MD, PhD, RCCA Chairperson of the Board and RCCA Pharmacy Medical Director and Eileen Peng, PharmD, Director of the RCCA Pharmacy agree that “this new recognition will allow us to continue to provide the highest level of patient care and convenience for the people that need it the most.”

 

“Pharmacy services have never played such an important role in the delivery of care as they do today. RCCA distinguishes itself for having voluntarily undergone a rigorous review of quality standards that earned it URAC accreditation,” said URAC President and CEO Kylanne Green. “Independent URAC accreditation shows RCCA is dedicated to quality and safety, and that it strives for a continual improvement of its services.”

ABOUT RCCA

Regional Cancer Care Associates (RCCA), one of the largest oncology physician networks in the United States, is transforming oncology care by ensuring that cancer patients have access to the highest-quality, most-comprehensive, cutting edge treatments in a compassionate and community-based setting. RCCA includes more than 100 cancer care specialists and is supported by 800 employees at more than 30 care delivery sites, providing care to more than 24,000 new patients annually and over 240,000 existing patients.  For more information visit: http://www.RCCA.com

About URAC

Founded in 1990, URAC is the independent leader in promoting healthcare quality through accreditation, certification and measurement. URAC is a nonprofit organization developing evidence-based measures and standards through inclusive engagement with a range of stakeholders committed to improving the quality of healthcare. Our portfolio of accreditation and certification programs span the healthcare industry, addressing healthcare management, healthcare operations, health plans, pharmacies, telehealth providers, physician practices, and more. URAC accreditation is a symbol of excellence for organizations to showcase their validated commitment to quality and accountability.

For further information, contact:

Mary Lou Salvemini
msalvemini@regionalcancercare.org
(201) 510-0922

RCCA Makes Innovative UnitedHealthcare Cancer Care Program Available to Patients in Maryland

HACKENSACK, N.J., Nov. 22, 2016 /PRNewswire-USNewswire/ — Regional Cancer Care Associates (RCCA) is expanding its cancer care payment initiative with UnitedHealthcare to RCCA patients in Maryland who are covered by UnitedHealthcare benefit plans.

The program, made available at RCCA New Jersey locations in January, rewards physicians for focusing on best treatment practices, quality patient care and better health outcomes. The program pays participating medical oncologists more if they demonstrate superior clinical results and if they reduce the total cost of care.

The episode payment model shifts reimbursement away from the current “fee-for-service” approach that emphasizes volume of care delivered regardless of a patient’s health outcomes. The episode payment is based on the expected cost of a standard treatment regimen for a specific condition, as predetermined by the doctor. Similar payment models have been shown to enhance care coordination and improve health outcomes for patients, while reducing overall costs.

“RCCA has emerged as a leader in delivering the highest-level quality cancer care to our patients,” said Terrill Jordan, RCCA President and CEO. “New payment methodologies like this put patients’ interests at the forefront of cancer treatment. It also results in significant cost savings, which advances efforts across the country to assist in controlling rising health care costs. We are excited to offer this program to our Maryland patient base.”

Lee N. Newcomer, M.D., UnitedHealthcare’s Senior Vice President, Oncology, said: “Our partnership with RCCA marks an important step toward expanded episode payment models and away from the traditional fee-for-service payments for oncology care. We look forward to working with RCCA and others to expand our efforts to identify best practices for treating cancer.”

A study published in the Journal of Oncology Practice has demonstrated that this program reduced overall cancer expenses by more than a third while improving quality outcomes. RCCA is among five oncology practices that have joined the program, which now has a total of more than 650 oncologists. RCCA in New Jersey and now Maryland comprise approximately 100 of these oncologists.

“Value-based cancer care is here. This program will enable Maryland-based RCCA oncologists to continue to provide patient-centered care at the highest level of quality,” said Ralph Boccia, M.D., RCCA Research Deputy Chair and Oncologist in Bethesda and Germantown, Md.

UnitedHealthcare first implemented its episode payment program as a pilot study between October 2009 and December 2012. The pilot study produced a significant reduction in hospitalizations and a 34 percent reduction in total costs while improving quality. Click here to read results of the study.

About RCCA
Regional Cancer Care Associates (RCCA), one of the largest oncology physician networks in the United States, is transforming oncology care by ensuring that cancer patients have access to the highest-quality, most-comprehensive, cutting edge treatments in a compassionate and community-based setting. RCCA includes 100 cancer care specialists and is supported by 700 employees at 27 care delivery sites, providing care to more than 230,000 existing patients in New Jersey, Maryland and Washington DC.  For more information visit: http://www.RCCA.com

Contact:

Mary Lou Salvemini
msalvemini@regionalcancercare.org
(201) 510-0922

REGIONAL CANCER CARE ASSOCIATES AND AETNA FORM ONCOLOGY MEDICAL HOME

REGIONAL CANCER CARE ASSOCIATES AND AETNA FORM ONCOLOGY MEDICAL HOME

— The Patient-Focused Model Supports High-Value Care–

 

Hackensack, NJ, October 12, 2016 — Regional Cancer Care Associates (RCCA) and Aetna (NYSE: AET) announced a collaboration to create an oncology medical home that is designed to improve the care experience for cancer patients.

In the oncology medical home model, teams of cancer specialists collectively provide a patient’s health care when he or she has a cancer diagnosis. The model will give RCCA the responsibility to arrange appropriate care that is continuous and proactive and physicians will be incentivized for improved health, affordability and a better patient experience.

The oncology medical home arrangement will be available to patients at all RCCA locations in New Jersey and Maryland.

“RCCA is excited to partner with Aetna on this program. It aligns with our vision of providing patient centered care close to home,” said Terrill Jordan, RCCA President & CEO. “This partnership will not only enable us to continue the delivery of high quality care through reduced side effects, but will also facilitate cost effective care based on the data Aetna will be sharing,” said Michael Ruiz de Somocurcio, RCCA Vice President of Payer and Provider Collaboration.

The model is part of a strategic direction to transition from fee-for-service medicine to value-based payment. Value-based arrangements are emerging as a solution to address rising health care costs, clinical inefficiency, duplication of services, and access to care. In value-based models, doctors and hospitals are paid for helping to keep people healthy and for improving the health of those who have chronic conditions in an evidence-based, cost-effective way.

“We understand that cancer treatment can be the hardest experience that our members will ever have to go through,” said Daniel Knecht, M.D., M.B.A., Aetna’s Head of Strategy & Planning and Interim Head of Oncology Solutions. “This oncology medical home with RCCA will help provide our members with high-quality care and an optimal patient experience.”

The operating principles of the RCCA and Aetna oncology medical home include:

  • An orientation to the whole person. A personal physician from RCCA will be responsible for providing or arranging all of a patient’s health care needs with other qualified professionals. This includes care for all stages of treatment: preventive services, acute care, chronic care, palliative care and end-of-life care.
  • Evidence-based, personalized medical care. The RCCA team will focus on making treatment decisions based on current medical evidence for each unique disease presentation, patient-specific factors and patient choice using appropriate treatments to improve quality and outcomes.
  • Coordinated and integrated care. Care will be facilitated, across all elements of the health system, to enable Aetna members to get the appropriate care when and where it is needed and wanted, in a culturally and linguistically appropriate manner.
  • Quality and safety. Quality and safety will be a focus of care, including the use of evidence-based medicine, clinical decision support tools and accountability for continuous quality improvement.
  • Enhanced access to care. Care will be available through systems such as open scheduling, expanded hours and new options for communication between Aetna members, their personal physicians and hospital staff.

The oncology medical home arrangement launched in September 2016.

About RCCA

Regional Cancer Care Associates (RCCA), one of the largest oncology physician networks in the United States, is transforming oncology care by ensuring that cancer patients have access to the highest-quality, most-comprehensive, cutting edge treatments in a compassionate and community-based setting. RCCA includes 100 cancer care specialists and is supported by 700 employees at 27 care delivery sites, providing care to more than 23,000 new patients annually and over 230,000 existing patients in New Jersey, Maryland and Washington DC. For more information visit: http://www.RCCA.com.

About Aetna

Aetna is one of the nation’s leading diversified health care benefits companies, serving an estimated 46.3 million people with information and resources to help them make better informed decisions about their health care. Aetna offers a broad range of traditional, voluntary and consumer-directed health insurance products and related services, including medical, pharmacy, dental, behavioral health, group life and disability plans, and medical management capabilities, Medicaid health care management services, workers’ compensation administrative services and health information technology products and services. Aetna’s customers include employer groups, individuals, college students, part-time and hourly workers, health plans, health care providers, governmental units, government-sponsored plans, labor groups and expatriates. For more information, see www.aetna.com and learn about how Aetna is helping to build a healthier world. @AetnaNews

 

###

What Cancer Patients Need To Know About Clinical Trials: Insights From New Jersey Hematologist /Oncologist Seth Berk

Seth Howard Berk, MD, a hematologist and medical oncologist with RCCA, reveals four facts that he shares with his patients when they ask about clinical trials.

First, a drug has been thoroughly tested well before it reaches the clinical trial stage. Pre-clinical trial testing involves looking at a drug’s effects on animals as well as human cells. This stage usually takes years of development. Also, the clinical studies have to be designed and conducted in accordance with rigorous ethical and safety criteria.

He also imparts the importance of not thinking of clinical trials as a last resort in treatment. While trials are typically suited for situations in which traditional therapy methods are not working for a patient, there is more evidence emerging of late-stage trials benefitting the patient when used early in the diagnosis process.

A myth that Dr. Berk debunks is the use of a placebo in cancer treatment. Some cancer patients are resistant to clinical trials because they fear there will be a placebo and they will suffer as a result. He says this is misinformation or something assumed from a patient’s memory of high school or college science experiments. In clinical trials, one group will be administered the trial agent while the other continues to have traditional therapy. There are rarely ever patients receiving zero care.

Lastly, Dr. Berk addresses the importance of clinical trials for cancer patients in general. Because of willing patients participating in more and more trials, doctors and patients can share in a community of knowledge and understanding, and, one day, a cure.

To read more about clinical trials, turn to “What cancer patients need to know about clinical trials: Insights from New Jersey oncologist/hematologist Seth Berk.”

RCCA: Taking Cancer Care To A Higher Level In NJ And Beyond

Edward J. Licitra, MD, PhD, board certified in internal medicine, hematology and medical oncology and chairman of the board of directors of Regional Cancer Care Associates (RCCA), shares some of his thoughts on potential models for a health care delivery reform system. Oncologists at RCCA, totaling 100 physicians, learn from each other’s best practices with the patient’s interest at the forefront. Through RCCA, patients can receive care at home instead of visiting a hospital or clinic. They have set up 27 care delivery sites, providing care to more than 23,000 new patients annually and approximately 230,000 existing patients in New Jersey, Maryland and Washington, D.C.

Another example of a successful care reform case is the Oncology Care Model (OCM) created by Medicare under the Affordable Care Act (ACA). The model questions how to best develop an integrated style of cancer care. It focuses on developing a care model for the future, using data sharing and streamlining economics for patients as well as providers. By digitizing patients’ medical histories and sharing them through hospitals and clinics, this model focuses on simplifying the oncology care process.

Lastly, the OCM utilizes evidence-based-medicine (EBM) practices throughout the entire spectrum of care. EBM produces the best methods regardless of cost, while even reducing cost by eliminating wasteful spending. The OCM focuses on patient-focused, research based therapy tailored to the individual patient.

To learn more about this topic, read “RCCA: Taking cancer care to a higher level in NJ and beyond.”

Targeting Treatments for Chronic Lymphocytic Leukemia

Dr. Joel Silver

 

How do myeloma and chronic lymphocytic leukemia (CLL) develop? What are some risk factors associated with those malignancies?

A. We don’t know what causes CLL. We do know that people in some occupations or with a certain exposure history might be at higher risk, and that CLL generally affects older people. Treatment fortunately is not needed in many cases, but even so our treatment options have evolved based on cytogenetics and next-generation sequencing. We have more ways to assess prognostic features and design more personalized and potentially more effective therapy for people with CLL.

 

What therapies have been successful in treating CLL over the last two to three years?

A. If you can identify a certain kind of CLL, such as IDH-mutated CLL, some of the patients with it can receive a standard chemotherapy regimen called FCR, and they sometimes go into remission indefinitely. It depends on whether the patient is young and healthy enough to tolerate the therapy. That’s a select group, though; you don’t see too many young people with CLL.

Years ago, an effective treatment did not exist for another group of patients with CLL, those with the genetic 17p deletion. In recent years, however, the oral agent ibrutinib has shown effectiveness for CLL in this group. Other therapies now are available for patients who don’t respond to ibrutinib.

 

Where does targeted therapy come into play?

A. In general, “targeted therapy” refers to a treatment based on a particular mutation or pattern. The presence of the genetic 17p deletion in CLL is one example, but this is a bad cytogenetic abnormality for which standard treatments such as chemotherapy haven’t worked. If we can identify a particular mutation, then we can target our therapy and plan treatment that we know will work, instead of going through chemotherapies that are only partially effective or downright ineffective and then finding that the patient is resistant to treatment.

 

Are there side effects or drawbacks to targeted therapy?

A. Everything we do has side effects. The oral agent ibrutinib has been an effective first-line therapy for any type of CLL. Although the agent is specifically for patients with 17p deletion, it has also worked for patients without that genetic feature. While some cardiovascular and bleeding issues have been reported, ibrutinib overall is more tolerable than chemotherapy.

When we medically examine patients with CLL, we always look at a pattern of mutations to try to identify how to treat these people — not so much from an immediate therapeutic standpoint, but to gain knowledge of all these other cytogenetic abnormalities so that eventually, we will find other ways to target those different patterns.

What important points do you address with patients before they begin CLL therapy?

A. Many people with CLL don’t die of their disease, they die with their disease, so I tell patients not to be afraid of the disease itself. Many of the conversations we have with these people, however, revolve around the fact that they have this problem but may never need treatment. “We should follow you because you may need treatment down the line,” I tell them. “If you need treatment, we have many effective therapies.”

 

Do you foresee different therapies for CLL emerging within the next two to three years?

A. A number of medications are on the horizon that will be appropriate for any patient with CLL. For example, venetoclax, which gained FDA approval last year, is indicated for second-line treatment of CLL in patients with the 17p deletion, but I think that agent will be effective for all patients with CLL. As similarly versatile agents are developed, we will have many more treatment options.

Colorectal Cancer Trends in Maryland: A Conversation with Dr. Ralph V. Boccia

As the third most common cancer in the United States, colorectal cancer (CRC) affects about 1 in 20 Americans. However, incidence and death rates for cancer of the colorectum have significantly decreased over the past several decades as a result of increased screening and drastic improvements in treatment. In Maryland alone, approximately 70% of adults over the age of 50 have an up-to-date colorectal cancer screening, helping contribute to the reduction in mortality rates.

Dr. Ralph V. Boccia, an oncology and hematology specialist at Regional Cancer Care Associates (RCCA) in Bethesda and Germantown, Maryland says, “The more colorectal screening we have and the earlier it gets started, the lower the stage that the cancer is typically picked up.” In turn, early detection has led to the state’s lower mortality rates over time.

 

The Benefits Of Increased Screening

According to Dr. Boccia, improving screening rates “affects the stage at which the cancer presents itself and [the patient’s] potential for survival.” Between 2002 and 2010, the percentage of Maryland adults with up-to-date colorectal cancer screenings increased from 64% to 71%. As a result, CRC mortality rates in Maryland decreased considerably among both men and women in that eight-year timeframe. Dr. Boccia explains, “The trend we’ve actually seen – which is that more people are being screened – has resulted in more improvements of overall survival in patients with colorectal cancer.”

However, as colon cancer rates decline in adults 50 years and older, both incidence and death rates are increasing in the under-50 population. “We’re seeing a scary trend of younger patients getting colorectal cancer,” remarks Dr. Boccia, “even down into the 20s.” However, at this point in time, there’s insufficient data to clearly identify the causation behind this trend.

 

Colorectal Cancer Risk Factors

According to a report from the Maryland Department of Health and Mental Hygiene, the incidence rate of colon cancer per 100,000 people in Maryland was 1,174 for men and 1,109 for women in 2012. When looking at new cases of CRC, research shows that incidence may be tied to habits and lifestyles. Among these lifestyle- associated risk factors are being overweight or obese, lack of physical activity, smoking, heavy alcohol use and certain types of diets.

As outlined by the American Cancer Society, other risk factors unrelated to lifestyle choices are personal and family histories of colorectal cancer or adenomatous polyps, having type 2 diabetes, possessing an inherited syndrome, such as Lynch Syndrome, and certain racial and ethnic backgrounds. In addition, Dr. Boccia notes that a personal history of inflammatory bowel disease may increase the risk for developing colorectal cancer. “Patients with ulcerative colitis have to be screened very frequently for colon cancer,” Dr. Boccia elucidates, “because of that high predisposition.”

 

Common CRC Treatments

“For early stage colorectal cancer, the treatment of choice is surgery,” says Dr. Boccia. In this stage, a group of abnormal cells, referred to as carcinoma in situ (CIS), can be removed by a polypectomy, or a part of the colon can be removed via a partial colectomy. Once the cancer has penetrated the wall of the colon and perhaps even grown into nearby tissue, patients of RCCA Maryland will typically undergo active surveillance – although other treatment options are offered to those with high-risk tumors, says Dr. Boccia.

Once the cancer has reached Stage III, patients are generally offered a form of chemotherapy for roughly six weeks. “FOLFOX is the adjuvant therapy of choice,” says Dr. Boccia, “and that we know will lower the incidence of recurrence by about 40-50%.” For Stage IV diseases, which make up about 20% of the cases that RCCA Maryland sees each year, chemotherapy, targeted therapy and even immunotherapy can be used to offer aggressive treatment. If they no longer respond to a particular drug, patients will be introduced to a new regimen.

In regards to new research and treatment options, Dr. Boccia concludes, “I have 50 to 60 clinical trials open at all times in the center, so we’re always looking actively for good, cutting-edge therapies and offering those to our patients.”

 

If you or someone you love has been diagnosed with colorectal cancer, schedule an appointment at one of RCCA’s 29 locations in New Jersey, Maryland or Connecticut for personalized, professional care.

Molecular Testing: Tailoring Treatment by Targeting Pathways

Phillip D. Reid, MD

 

What is molecular testing? How it is used in cancer care?

A.  As we learn how to treat specific subtypes of cancer more accurately, molecular testing, molecular medicine and molecular diagnostics are becoming more prominent in oncology.

In the past, once a cancer was diagnosed, we determined the organ where it started, how much cancer was in the body and where it was. We have since discovered many pathways through which a cancer develops. We now need to know not only the stage, type and origin of cancer, but also the pathway through which it developed and then target that pathway.

 

How does the pathway concept affect therapy selection?

A.  It enhances our ability to treat the cancer, but we now need extra testing on a patient’s particular cancer cells. The great thing about molecular testing is we get an answer specific for the individual, not just for everyone, for example, with lung cancer. But it does require more time for us to find the pathway. From the patient’s standpoint, diagnosis and stage are obtained, and then sometimes we have to send off the cancer cells for extra testing, which increases the time between diagnosis and treatment. But ultimately, a better sense is provided of what drug to use and when to use it, and there’s a much greater likelihood of devising specific, effective treatment.

 

For which types of cancer should molecular testing be used?

A.  Molecular testing has revolutionized every major cancer diagnosis. Patients with lung and breast cancer are the best candidates, but molecular testing also is useful in colon cancer, head-and-neck and bladder cancer, and some leukemias and myelomas.

 

What have been the main developments over the last two to three years with molecular testing?

A.  It’s becoming easier and more standardized to get molecular testing done. A patient receives a diagnosis and his or her cancer is sent off to a lab, which evaluates all known pathways for that cancer. A specific result is received. As the patient receives therapy, sometimes the cancer changes and he or she may need a second or third biopsy one to three years after the initial diagnosis to see what’s changed in the cancer, and then the treatment changes based on that result. We now see cancer as a moving target as it progresses, and we have to recalibrate every few years so that we’re shooting that target correctly.

 

What should patients know about molecular testing before proceeding?

A.  After a patient receives his or her staging diagnosis, the next question is, “What subtype of lung cancer do I have and what pathway did the cancer use to develop?” The patient needs to have patience, as that extra information may not arrive for two to four weeks, but that information can increase the chances of treatment success.

Also ask about clinical trials of cancer medications before beginning therapy, because we often know about upcoming medications that are effective and possibly better than what we have right now.

Colorectal Cancer Trends and Treatment

Ralph V. Boccia, MD, a cancer specialist at RCCA Maryland, provides some insight into recent colorectal cancer trends and treatments that are giving new hope to doctors, researchers and patients nationwide. Overall, Dr. Boccia finds much to be encouraged by, but also points to the need for awareness of a concerning development in the field of colorectal cancer.

 

How Far We’ve Come and Where We’re Going

As a whole, colorectal cancer rates have been dropping. According to the National Cancer Institute and Centers for Disease Control and Prevention, Maryland alone has seen a 2.6% decrease in the amount of new CRC patients diagnosed over a five-year period. Dr. Boccia believes this trend can be partly attributed to the following:

  • Widespread increase in colonoscopies and other CRC screening methods
  • Early detection and removal of polyps before they become cancerous
  • More cases being diagnosed at an early stage – when the cancer is more responsive to treatment

Despite the good news, it’s still projected that 2,358 Maryland residents will be diagnosed and that 927 people will die from the disease this year, says Dr. Boccia. Doctors have also been noticing an uncharacteristic increase in the amount of younger adults being diagnosed with CRC. Since it typically affects individuals above the age of 50, this emerging demographic has been cause for concern. But Dr. Boccia and his colleagues will continue to conduct research and make further strides in colorectal cancer care to better serve patients of all ages.

 

Current Treatment Options

Surgical innovations, targeted therapies, immunotherapies, chemotherapy and clinical trials are paving the way for more effective CRC solutions. Dr. Boccia explains, “We have a greater ability than ever before to individualize care, and to offer patients multi-modal treatment regimens that employ a variety of mechanisms of action to combat cancer by different means.”

 

Reducing Your Risk

Follow these tips to help reduce your risk for developing colorectal cancer:

  • Maintain a healthy weight
  • Stay physically active
  • Avoid smoking cigarettes and only drink alcohol in moderation
  • Get a CRC screening regularly
  • Consult a physician right away if you experience any CRC symptoms, such as blood in the stool and persistent abdominal pain
  • Manage other conditions that may increase your risk for CRC, like type 2 diabetes, inflammatory bowel disease and adenomatous polyps

 

If you or someone you love has been diagnosed with colorectal cancer, schedule an appointment at one of RCCA’s 29 locations in New Jersey, Maryland or Connecticut for personalized, professional care.

RCCA Earns URAC Accreditation In Specialty Pharmacy

[Hackensack, NJ] – RCCA is proud to announce that it has earned URAC accreditation in Specialty Pharmacy. URAC is the independent leader in promoting healthcare quality through accreditation, certification and measurement. By achieving this status, RCCA has demonstrated a comprehensive commitment to quality care, improved processes and better patient outcomes.

 

“URAC Accreditation is a testament to the commitment of delivering the highest level of quality standards to our patients and their caregivers,” said Terrill Jordan, President and CEO of RCCA. ”This type of commitment is the cornerstone of everything we do at RCCA,” he added.

Edward Licitra, MD, PhD, RCCA Chairperson of the Board and RCCA Pharmacy Medical Director and Eileen Peng, PharmD, Director of the RCCA Pharmacy agree that “this new recognition will allow us to continue to provide the highest level of patient care and convenience for the people that need it the most.”

 

“Pharmacy services have never played such an important role in the delivery of care as they do today. RCCA distinguishes itself for having voluntarily undergone a rigorous review of quality standards that earned it URAC accreditation,” said URAC President and CEO Kylanne Green. “Independent URAC accreditation shows RCCA is dedicated to quality and safety, and that it strives for a continual improvement of its services.”

ABOUT RCCA

Regional Cancer Care Associates (RCCA), one of the largest oncology physician networks in the United States, is transforming oncology care by ensuring that cancer patients have access to the highest-quality, most-comprehensive, cutting edge treatments in a compassionate and community-based setting. RCCA includes more than 100 cancer care specialists and is supported by 800 employees at more than 30 care delivery sites, providing care to more than 24,000 new patients annually and over 240,000 existing patients.  For more information visit: http://www.RCCA.com

About URAC

Founded in 1990, URAC is the independent leader in promoting healthcare quality through accreditation, certification and measurement. URAC is a nonprofit organization developing evidence-based measures and standards through inclusive engagement with a range of stakeholders committed to improving the quality of healthcare. Our portfolio of accreditation and certification programs span the healthcare industry, addressing healthcare management, healthcare operations, health plans, pharmacies, telehealth providers, physician practices, and more. URAC accreditation is a symbol of excellence for organizations to showcase their validated commitment to quality and accountability.

For further information, contact:

Mary Lou Salvemini
msalvemini@regionalcancercare.org
(201) 510-0922

RCCA Makes Innovative UnitedHealthcare Cancer Care Program Available to Patients in Maryland

HACKENSACK, N.J., Nov. 22, 2016 /PRNewswire-USNewswire/ — Regional Cancer Care Associates (RCCA) is expanding its cancer care payment initiative with UnitedHealthcare to RCCA patients in Maryland who are covered by UnitedHealthcare benefit plans.

The program, made available at RCCA New Jersey locations in January, rewards physicians for focusing on best treatment practices, quality patient care and better health outcomes. The program pays participating medical oncologists more if they demonstrate superior clinical results and if they reduce the total cost of care.

The episode payment model shifts reimbursement away from the current “fee-for-service” approach that emphasizes volume of care delivered regardless of a patient’s health outcomes. The episode payment is based on the expected cost of a standard treatment regimen for a specific condition, as predetermined by the doctor. Similar payment models have been shown to enhance care coordination and improve health outcomes for patients, while reducing overall costs.

“RCCA has emerged as a leader in delivering the highest-level quality cancer care to our patients,” said Terrill Jordan, RCCA President and CEO. “New payment methodologies like this put patients’ interests at the forefront of cancer treatment. It also results in significant cost savings, which advances efforts across the country to assist in controlling rising health care costs. We are excited to offer this program to our Maryland patient base.”

Lee N. Newcomer, M.D., UnitedHealthcare’s Senior Vice President, Oncology, said: “Our partnership with RCCA marks an important step toward expanded episode payment models and away from the traditional fee-for-service payments for oncology care. We look forward to working with RCCA and others to expand our efforts to identify best practices for treating cancer.”

A study published in the Journal of Oncology Practice has demonstrated that this program reduced overall cancer expenses by more than a third while improving quality outcomes. RCCA is among five oncology practices that have joined the program, which now has a total of more than 650 oncologists. RCCA in New Jersey and now Maryland comprise approximately 100 of these oncologists.

“Value-based cancer care is here. This program will enable Maryland-based RCCA oncologists to continue to provide patient-centered care at the highest level of quality,” said Ralph Boccia, M.D., RCCA Research Deputy Chair and Oncologist in Bethesda and Germantown, Md.

UnitedHealthcare first implemented its episode payment program as a pilot study between October 2009 and December 2012. The pilot study produced a significant reduction in hospitalizations and a 34 percent reduction in total costs while improving quality. Click here to read results of the study.

About RCCA
Regional Cancer Care Associates (RCCA), one of the largest oncology physician networks in the United States, is transforming oncology care by ensuring that cancer patients have access to the highest-quality, most-comprehensive, cutting edge treatments in a compassionate and community-based setting. RCCA includes 100 cancer care specialists and is supported by 700 employees at 27 care delivery sites, providing care to more than 230,000 existing patients in New Jersey, Maryland and Washington DC.  For more information visit: http://www.RCCA.com

Contact:

Mary Lou Salvemini
msalvemini@regionalcancercare.org
(201) 510-0922

REGIONAL CANCER CARE ASSOCIATES AND AETNA FORM ONCOLOGY MEDICAL HOME

REGIONAL CANCER CARE ASSOCIATES AND AETNA FORM ONCOLOGY MEDICAL HOME

— The Patient-Focused Model Supports High-Value Care–

 

Hackensack, NJ, October 12, 2016 — Regional Cancer Care Associates (RCCA) and Aetna (NYSE: AET) announced a collaboration to create an oncology medical home that is designed to improve the care experience for cancer patients.

In the oncology medical home model, teams of cancer specialists collectively provide a patient’s health care when he or she has a cancer diagnosis. The model will give RCCA the responsibility to arrange appropriate care that is continuous and proactive and physicians will be incentivized for improved health, affordability and a better patient experience.

The oncology medical home arrangement will be available to patients at all RCCA locations in New Jersey and Maryland.

“RCCA is excited to partner with Aetna on this program. It aligns with our vision of providing patient centered care close to home,” said Terrill Jordan, RCCA President & CEO. “This partnership will not only enable us to continue the delivery of high quality care through reduced side effects, but will also facilitate cost effective care based on the data Aetna will be sharing,” said Michael Ruiz de Somocurcio, RCCA Vice President of Payer and Provider Collaboration.

The model is part of a strategic direction to transition from fee-for-service medicine to value-based payment. Value-based arrangements are emerging as a solution to address rising health care costs, clinical inefficiency, duplication of services, and access to care. In value-based models, doctors and hospitals are paid for helping to keep people healthy and for improving the health of those who have chronic conditions in an evidence-based, cost-effective way.

“We understand that cancer treatment can be the hardest experience that our members will ever have to go through,” said Daniel Knecht, M.D., M.B.A., Aetna’s Head of Strategy & Planning and Interim Head of Oncology Solutions. “This oncology medical home with RCCA will help provide our members with high-quality care and an optimal patient experience.”

The operating principles of the RCCA and Aetna oncology medical home include:

  • An orientation to the whole person. A personal physician from RCCA will be responsible for providing or arranging all of a patient’s health care needs with other qualified professionals. This includes care for all stages of treatment: preventive services, acute care, chronic care, palliative care and end-of-life care.
  • Evidence-based, personalized medical care. The RCCA team will focus on making treatment decisions based on current medical evidence for each unique disease presentation, patient-specific factors and patient choice using appropriate treatments to improve quality and outcomes.
  • Coordinated and integrated care. Care will be facilitated, across all elements of the health system, to enable Aetna members to get the appropriate care when and where it is needed and wanted, in a culturally and linguistically appropriate manner.
  • Quality and safety. Quality and safety will be a focus of care, including the use of evidence-based medicine, clinical decision support tools and accountability for continuous quality improvement.
  • Enhanced access to care. Care will be available through systems such as open scheduling, expanded hours and new options for communication between Aetna members, their personal physicians and hospital staff.

The oncology medical home arrangement launched in September 2016.

About RCCA

Regional Cancer Care Associates (RCCA), one of the largest oncology physician networks in the United States, is transforming oncology care by ensuring that cancer patients have access to the highest-quality, most-comprehensive, cutting edge treatments in a compassionate and community-based setting. RCCA includes 100 cancer care specialists and is supported by 700 employees at 27 care delivery sites, providing care to more than 23,000 new patients annually and over 230,000 existing patients in New Jersey, Maryland and Washington DC. For more information visit: http://www.RCCA.com.

About Aetna

Aetna is one of the nation’s leading diversified health care benefits companies, serving an estimated 46.3 million people with information and resources to help them make better informed decisions about their health care. Aetna offers a broad range of traditional, voluntary and consumer-directed health insurance products and related services, including medical, pharmacy, dental, behavioral health, group life and disability plans, and medical management capabilities, Medicaid health care management services, workers’ compensation administrative services and health information technology products and services. Aetna’s customers include employer groups, individuals, college students, part-time and hourly workers, health plans, health care providers, governmental units, government-sponsored plans, labor groups and expatriates. For more information, see www.aetna.com and learn about how Aetna is helping to build a healthier world. @AetnaNews

 

###

What Cancer Patients Need To Know About Clinical Trials: Insights From New Jersey Hematologist /Oncologist Seth Berk

Seth Howard Berk, MD, a hematologist and medical oncologist with RCCA, reveals four facts that he shares with his patients when they ask about clinical trials.

First, a drug has been thoroughly tested well before it reaches the clinical trial stage. Pre-clinical trial testing involves looking at a drug’s effects on animals as well as human cells. This stage usually takes years of development. Also, the clinical studies have to be designed and conducted in accordance with rigorous ethical and safety criteria.

He also imparts the importance of not thinking of clinical trials as a last resort in treatment. While trials are typically suited for situations in which traditional therapy methods are not working for a patient, there is more evidence emerging of late-stage trials benefitting the patient when used early in the diagnosis process.

A myth that Dr. Berk debunks is the use of a placebo in cancer treatment. Some cancer patients are resistant to clinical trials because they fear there will be a placebo and they will suffer as a result. He says this is misinformation or something assumed from a patient’s memory of high school or college science experiments. In clinical trials, one group will be administered the trial agent while the other continues to have traditional therapy. There are rarely ever patients receiving zero care.

Lastly, Dr. Berk addresses the importance of clinical trials for cancer patients in general. Because of willing patients participating in more and more trials, doctors and patients can share in a community of knowledge and understanding, and, one day, a cure.

To read more about clinical trials, turn to “What cancer patients need to know about clinical trials: Insights from New Jersey oncologist/hematologist Seth Berk.”

RCCA: Taking Cancer Care To A Higher Level In NJ And Beyond

Edward J. Licitra, MD, PhD, board certified in internal medicine, hematology and medical oncology and chairman of the board of directors of Regional Cancer Care Associates (RCCA), shares some of his thoughts on potential models for a health care delivery reform system. Oncologists at RCCA, totaling 100 physicians, learn from each other’s best practices with the patient’s interest at the forefront. Through RCCA, patients can receive care at home instead of visiting a hospital or clinic. They have set up 27 care delivery sites, providing care to more than 23,000 new patients annually and approximately 230,000 existing patients in New Jersey, Maryland and Washington, D.C.

Another example of a successful care reform case is the Oncology Care Model (OCM) created by Medicare under the Affordable Care Act (ACA). The model questions how to best develop an integrated style of cancer care. It focuses on developing a care model for the future, using data sharing and streamlining economics for patients as well as providers. By digitizing patients’ medical histories and sharing them through hospitals and clinics, this model focuses on simplifying the oncology care process.

Lastly, the OCM utilizes evidence-based-medicine (EBM) practices throughout the entire spectrum of care. EBM produces the best methods regardless of cost, while even reducing cost by eliminating wasteful spending. The OCM focuses on patient-focused, research based therapy tailored to the individual patient.

To learn more about this topic, read “RCCA: Taking cancer care to a higher level in NJ and beyond.”

Targeting Treatments for Chronic Lymphocytic Leukemia

Dr. Joel Silver

 

How do myeloma and chronic lymphocytic leukemia (CLL) develop? What are some risk factors associated with those malignancies?

A. We don’t know what causes CLL. We do know that people in some occupations or with a certain exposure history might be at higher risk, and that CLL generally affects older people. Treatment fortunately is not needed in many cases, but even so our treatment options have evolved based on cytogenetics and next-generation sequencing. We have more ways to assess prognostic features and design more personalized and potentially more effective therapy for people with CLL.

 

What therapies have been successful in treating CLL over the last two to three years?

A. If you can identify a certain kind of CLL, such as IDH-mutated CLL, some of the patients with it can receive a standard chemotherapy regimen called FCR, and they sometimes go into remission indefinitely. It depends on whether the patient is young and healthy enough to tolerate the therapy. That’s a select group, though; you don’t see too many young people with CLL.

Years ago, an effective treatment did not exist for another group of patients with CLL, those with the genetic 17p deletion. In recent years, however, the oral agent ibrutinib has shown effectiveness for CLL in this group. Other therapies now are available for patients who don’t respond to ibrutinib.

 

Where does targeted therapy come into play?

A. In general, “targeted therapy” refers to a treatment based on a particular mutation or pattern. The presence of the genetic 17p deletion in CLL is one example, but this is a bad cytogenetic abnormality for which standard treatments such as chemotherapy haven’t worked. If we can identify a particular mutation, then we can target our therapy and plan treatment that we know will work, instead of going through chemotherapies that are only partially effective or downright ineffective and then finding that the patient is resistant to treatment.

 

Are there side effects or drawbacks to targeted therapy?

A. Everything we do has side effects. The oral agent ibrutinib has been an effective first-line therapy for any type of CLL. Although the agent is specifically for patients with 17p deletion, it has also worked for patients without that genetic feature. While some cardiovascular and bleeding issues have been reported, ibrutinib overall is more tolerable than chemotherapy.

When we medically examine patients with CLL, we always look at a pattern of mutations to try to identify how to treat these people — not so much from an immediate therapeutic standpoint, but to gain knowledge of all these other cytogenetic abnormalities so that eventually, we will find other ways to target those different patterns.

What important points do you address with patients before they begin CLL therapy?

A. Many people with CLL don’t die of their disease, they die with their disease, so I tell patients not to be afraid of the disease itself. Many of the conversations we have with these people, however, revolve around the fact that they have this problem but may never need treatment. “We should follow you because you may need treatment down the line,” I tell them. “If you need treatment, we have many effective therapies.”

 

Do you foresee different therapies for CLL emerging within the next two to three years?

A. A number of medications are on the horizon that will be appropriate for any patient with CLL. For example, venetoclax, which gained FDA approval last year, is indicated for second-line treatment of CLL in patients with the 17p deletion, but I think that agent will be effective for all patients with CLL. As similarly versatile agents are developed, we will have many more treatment options.

Colorectal Cancer Trends in Maryland: A Conversation with Dr. Ralph V. Boccia

As the third most common cancer in the United States, colorectal cancer (CRC) affects about 1 in 20 Americans. However, incidence and death rates for cancer of the colorectum have significantly decreased over the past several decades as a result of increased screening and drastic improvements in treatment. In Maryland alone, approximately 70% of adults over the age of 50 have an up-to-date colorectal cancer screening, helping contribute to the reduction in mortality rates.

Dr. Ralph V. Boccia, an oncology and hematology specialist at Regional Cancer Care Associates (RCCA) in Bethesda and Germantown, Maryland says, “The more colorectal screening we have and the earlier it gets started, the lower the stage that the cancer is typically picked up.” In turn, early detection has led to the state’s lower mortality rates over time.

 

The Benefits Of Increased Screening

According to Dr. Boccia, improving screening rates “affects the stage at which the cancer presents itself and [the patient’s] potential for survival.” Between 2002 and 2010, the percentage of Maryland adults with up-to-date colorectal cancer screenings increased from 64% to 71%. As a result, CRC mortality rates in Maryland decreased considerably among both men and women in that eight-year timeframe. Dr. Boccia explains, “The trend we’ve actually seen – which is that more people are being screened – has resulted in more improvements of overall survival in patients with colorectal cancer.”

However, as colon cancer rates decline in adults 50 years and older, both incidence and death rates are increasing in the under-50 population. “We’re seeing a scary trend of younger patients getting colorectal cancer,” remarks Dr. Boccia, “even down into the 20s.” However, at this point in time, there’s insufficient data to clearly identify the causation behind this trend.

 

Colorectal Cancer Risk Factors

According to a report from the Maryland Department of Health and Mental Hygiene, the incidence rate of colon cancer per 100,000 people in Maryland was 1,174 for men and 1,109 for women in 2012. When looking at new cases of CRC, research shows that incidence may be tied to habits and lifestyles. Among these lifestyle- associated risk factors are being overweight or obese, lack of physical activity, smoking, heavy alcohol use and certain types of diets.

As outlined by the American Cancer Society, other risk factors unrelated to lifestyle choices are personal and family histories of colorectal cancer or adenomatous polyps, having type 2 diabetes, possessing an inherited syndrome, such as Lynch Syndrome, and certain racial and ethnic backgrounds. In addition, Dr. Boccia notes that a personal history of inflammatory bowel disease may increase the risk for developing colorectal cancer. “Patients with ulcerative colitis have to be screened very frequently for colon cancer,” Dr. Boccia elucidates, “because of that high predisposition.”

 

Common CRC Treatments

“For early stage colorectal cancer, the treatment of choice is surgery,” says Dr. Boccia. In this stage, a group of abnormal cells, referred to as carcinoma in situ (CIS), can be removed by a polypectomy, or a part of the colon can be removed via a partial colectomy. Once the cancer has penetrated the wall of the colon and perhaps even grown into nearby tissue, patients of RCCA Maryland will typically undergo active surveillance – although other treatment options are offered to those with high-risk tumors, says Dr. Boccia.

Once the cancer has reached Stage III, patients are generally offered a form of chemotherapy for roughly six weeks. “FOLFOX is the adjuvant therapy of choice,” says Dr. Boccia, “and that we know will lower the incidence of recurrence by about 40-50%.” For Stage IV diseases, which make up about 20% of the cases that RCCA Maryland sees each year, chemotherapy, targeted therapy and even immunotherapy can be used to offer aggressive treatment. If they no longer respond to a particular drug, patients will be introduced to a new regimen.

In regards to new research and treatment options, Dr. Boccia concludes, “I have 50 to 60 clinical trials open at all times in the center, so we’re always looking actively for good, cutting-edge therapies and offering those to our patients.”

 

If you or someone you love has been diagnosed with colorectal cancer, schedule an appointment at one of RCCA’s 29 locations in New Jersey, Maryland or Connecticut for personalized, professional care.

Molecular Testing: Tailoring Treatment by Targeting Pathways

Phillip D. Reid, MD

 

What is molecular testing? How it is used in cancer care?

A.  As we learn how to treat specific subtypes of cancer more accurately, molecular testing, molecular medicine and molecular diagnostics are becoming more prominent in oncology.

In the past, once a cancer was diagnosed, we determined the organ where it started, how much cancer was in the body and where it was. We have since discovered many pathways through which a cancer develops. We now need to know not only the stage, type and origin of cancer, but also the pathway through which it developed and then target that pathway.

 

How does the pathway concept affect therapy selection?

A.  It enhances our ability to treat the cancer, but we now need extra testing on a patient’s particular cancer cells. The great thing about molecular testing is we get an answer specific for the individual, not just for everyone, for example, with lung cancer. But it does require more time for us to find the pathway. From the patient’s standpoint, diagnosis and stage are obtained, and then sometimes we have to send off the cancer cells for extra testing, which increases the time between diagnosis and treatment. But ultimately, a better sense is provided of what drug to use and when to use it, and there’s a much greater likelihood of devising specific, effective treatment.

 

For which types of cancer should molecular testing be used?

A.  Molecular testing has revolutionized every major cancer diagnosis. Patients with lung and breast cancer are the best candidates, but molecular testing also is useful in colon cancer, head-and-neck and bladder cancer, and some leukemias and myelomas.

 

What have been the main developments over the last two to three years with molecular testing?

A.  It’s becoming easier and more standardized to get molecular testing done. A patient receives a diagnosis and his or her cancer is sent off to a lab, which evaluates all known pathways for that cancer. A specific result is received. As the patient receives therapy, sometimes the cancer changes and he or she may need a second or third biopsy one to three years after the initial diagnosis to see what’s changed in the cancer, and then the treatment changes based on that result. We now see cancer as a moving target as it progresses, and we have to recalibrate every few years so that we’re shooting that target correctly.

 

What should patients know about molecular testing before proceeding?

A.  After a patient receives his or her staging diagnosis, the next question is, “What subtype of lung cancer do I have and what pathway did the cancer use to develop?” The patient needs to have patience, as that extra information may not arrive for two to four weeks, but that information can increase the chances of treatment success.

Also ask about clinical trials of cancer medications before beginning therapy, because we often know about upcoming medications that are effective and possibly better than what we have right now.

Colorectal Cancer Trends and Treatment

Ralph V. Boccia, MD, a cancer specialist at RCCA Maryland, provides some insight into recent colorectal cancer trends and treatments that are giving new hope to doctors, researchers and patients nationwide. Overall, Dr. Boccia finds much to be encouraged by, but also points to the need for awareness of a concerning development in the field of colorectal cancer.

 

How Far We’ve Come and Where We’re Going

As a whole, colorectal cancer rates have been dropping. According to the National Cancer Institute and Centers for Disease Control and Prevention, Maryland alone has seen a 2.6% decrease in the amount of new CRC patients diagnosed over a five-year period. Dr. Boccia believes this trend can be partly attributed to the following:

  • Widespread increase in colonoscopies and other CRC screening methods
  • Early detection and removal of polyps before they become cancerous
  • More cases being diagnosed at an early stage – when the cancer is more responsive to treatment

Despite the good news, it’s still projected that 2,358 Maryland residents will be diagnosed and that 927 people will die from the disease this year, says Dr. Boccia. Doctors have also been noticing an uncharacteristic increase in the amount of younger adults being diagnosed with CRC. Since it typically affects individuals above the age of 50, this emerging demographic has been cause for concern. But Dr. Boccia and his colleagues will continue to conduct research and make further strides in colorectal cancer care to better serve patients of all ages.

 

Current Treatment Options

Surgical innovations, targeted therapies, immunotherapies, chemotherapy and clinical trials are paving the way for more effective CRC solutions. Dr. Boccia explains, “We have a greater ability than ever before to individualize care, and to offer patients multi-modal treatment regimens that employ a variety of mechanisms of action to combat cancer by different means.”

 

Reducing Your Risk

Follow these tips to help reduce your risk for developing colorectal cancer:

  • Maintain a healthy weight
  • Stay physically active
  • Avoid smoking cigarettes and only drink alcohol in moderation
  • Get a CRC screening regularly
  • Consult a physician right away if you experience any CRC symptoms, such as blood in the stool and persistent abdominal pain
  • Manage other conditions that may increase your risk for CRC, like type 2 diabetes, inflammatory bowel disease and adenomatous polyps

 

If you or someone you love has been diagnosed with colorectal cancer, schedule an appointment at one of RCCA’s 29 locations in New Jersey, Maryland or Connecticut for personalized, professional care.

RCCA Earns URAC Accreditation In Specialty Pharmacy

[Hackensack, NJ] – RCCA is proud to announce that it has earned URAC accreditation in Specialty Pharmacy. URAC is the independent leader in promoting healthcare quality through accreditation, certification and measurement. By achieving this status, RCCA has demonstrated a comprehensive commitment to quality care, improved processes and better patient outcomes.

 

“URAC Accreditation is a testament to the commitment of delivering the highest level of quality standards to our patients and their caregivers,” said Terrill Jordan, President and CEO of RCCA. ”This type of commitment is the cornerstone of everything we do at RCCA,” he added.

Edward Licitra, MD, PhD, RCCA Chairperson of the Board and RCCA Pharmacy Medical Director and Eileen Peng, PharmD, Director of the RCCA Pharmacy agree that “this new recognition will allow us to continue to provide the highest level of patient care and convenience for the people that need it the most.”

 

“Pharmacy services have never played such an important role in the delivery of care as they do today. RCCA distinguishes itself for having voluntarily undergone a rigorous review of quality standards that earned it URAC accreditation,” said URAC President and CEO Kylanne Green. “Independent URAC accreditation shows RCCA is dedicated to quality and safety, and that it strives for a continual improvement of its services.”

ABOUT RCCA

Regional Cancer Care Associates (RCCA), one of the largest oncology physician networks in the United States, is transforming oncology care by ensuring that cancer patients have access to the highest-quality, most-comprehensive, cutting edge treatments in a compassionate and community-based setting. RCCA includes more than 100 cancer care specialists and is supported by 800 employees at more than 30 care delivery sites, providing care to more than 24,000 new patients annually and over 240,000 existing patients.  For more information visit: http://www.RCCA.com

About URAC

Founded in 1990, URAC is the independent leader in promoting healthcare quality through accreditation, certification and measurement. URAC is a nonprofit organization developing evidence-based measures and standards through inclusive engagement with a range of stakeholders committed to improving the quality of healthcare. Our portfolio of accreditation and certification programs span the healthcare industry, addressing healthcare management, healthcare operations, health plans, pharmacies, telehealth providers, physician practices, and more. URAC accreditation is a symbol of excellence for organizations to showcase their validated commitment to quality and accountability.

For further information, contact:

Mary Lou Salvemini
msalvemini@regionalcancercare.org
(201) 510-0922

RCCA Makes Innovative UnitedHealthcare Cancer Care Program Available to Patients in Maryland

HACKENSACK, N.J., Nov. 22, 2016 /PRNewswire-USNewswire/ — Regional Cancer Care Associates (RCCA) is expanding its cancer care payment initiative with UnitedHealthcare to RCCA patients in Maryland who are covered by UnitedHealthcare benefit plans.

The program, made available at RCCA New Jersey locations in January, rewards physicians for focusing on best treatment practices, quality patient care and better health outcomes. The program pays participating medical oncologists more if they demonstrate superior clinical results and if they reduce the total cost of care.

The episode payment model shifts reimbursement away from the current “fee-for-service” approach that emphasizes volume of care delivered regardless of a patient’s health outcomes. The episode payment is based on the expected cost of a standard treatment regimen for a specific condition, as predetermined by the doctor. Similar payment models have been shown to enhance care coordination and improve health outcomes for patients, while reducing overall costs.

“RCCA has emerged as a leader in delivering the highest-level quality cancer care to our patients,” said Terrill Jordan, RCCA President and CEO. “New payment methodologies like this put patients’ interests at the forefront of cancer treatment. It also results in significant cost savings, which advances efforts across the country to assist in controlling rising health care costs. We are excited to offer this program to our Maryland patient base.”

Lee N. Newcomer, M.D., UnitedHealthcare’s Senior Vice President, Oncology, said: “Our partnership with RCCA marks an important step toward expanded episode payment models and away from the traditional fee-for-service payments for oncology care. We look forward to working with RCCA and others to expand our efforts to identify best practices for treating cancer.”

A study published in the Journal of Oncology Practice has demonstrated that this program reduced overall cancer expenses by more than a third while improving quality outcomes. RCCA is among five oncology practices that have joined the program, which now has a total of more than 650 oncologists. RCCA in New Jersey and now Maryland comprise approximately 100 of these oncologists.

“Value-based cancer care is here. This program will enable Maryland-based RCCA oncologists to continue to provide patient-centered care at the highest level of quality,” said Ralph Boccia, M.D., RCCA Research Deputy Chair and Oncologist in Bethesda and Germantown, Md.

UnitedHealthcare first implemented its episode payment program as a pilot study between October 2009 and December 2012. The pilot study produced a significant reduction in hospitalizations and a 34 percent reduction in total costs while improving quality. Click here to read results of the study.

About RCCA
Regional Cancer Care Associates (RCCA), one of the largest oncology physician networks in the United States, is transforming oncology care by ensuring that cancer patients have access to the highest-quality, most-comprehensive, cutting edge treatments in a compassionate and community-based setting. RCCA includes 100 cancer care specialists and is supported by 700 employees at 27 care delivery sites, providing care to more than 230,000 existing patients in New Jersey, Maryland and Washington DC.  For more information visit: http://www.RCCA.com

Contact:

Mary Lou Salvemini
msalvemini@regionalcancercare.org
(201) 510-0922

REGIONAL CANCER CARE ASSOCIATES AND AETNA FORM ONCOLOGY MEDICAL HOME

REGIONAL CANCER CARE ASSOCIATES AND AETNA FORM ONCOLOGY MEDICAL HOME

— The Patient-Focused Model Supports High-Value Care–

 

Hackensack, NJ, October 12, 2016 — Regional Cancer Care Associates (RCCA) and Aetna (NYSE: AET) announced a collaboration to create an oncology medical home that is designed to improve the care experience for cancer patients.

In the oncology medical home model, teams of cancer specialists collectively provide a patient’s health care when he or she has a cancer diagnosis. The model will give RCCA the responsibility to arrange appropriate care that is continuous and proactive and physicians will be incentivized for improved health, affordability and a better patient experience.

The oncology medical home arrangement will be available to patients at all RCCA locations in New Jersey and Maryland.

“RCCA is excited to partner with Aetna on this program. It aligns with our vision of providing patient centered care close to home,” said Terrill Jordan, RCCA President & CEO. “This partnership will not only enable us to continue the delivery of high quality care through reduced side effects, but will also facilitate cost effective care based on the data Aetna will be sharing,” said Michael Ruiz de Somocurcio, RCCA Vice President of Payer and Provider Collaboration.

The model is part of a strategic direction to transition from fee-for-service medicine to value-based payment. Value-based arrangements are emerging as a solution to address rising health care costs, clinical inefficiency, duplication of services, and access to care. In value-based models, doctors and hospitals are paid for helping to keep people healthy and for improving the health of those who have chronic conditions in an evidence-based, cost-effective way.

“We understand that cancer treatment can be the hardest experience that our members will ever have to go through,” said Daniel Knecht, M.D., M.B.A., Aetna’s Head of Strategy & Planning and Interim Head of Oncology Solutions. “This oncology medical home with RCCA will help provide our members with high-quality care and an optimal patient experience.”

The operating principles of the RCCA and Aetna oncology medical home include:

  • An orientation to the whole person. A personal physician from RCCA will be responsible for providing or arranging all of a patient’s health care needs with other qualified professionals. This includes care for all stages of treatment: preventive services, acute care, chronic care, palliative care and end-of-life care.
  • Evidence-based, personalized medical care. The RCCA team will focus on making treatment decisions based on current medical evidence for each unique disease presentation, patient-specific factors and patient choice using appropriate treatments to improve quality and outcomes.
  • Coordinated and integrated care. Care will be facilitated, across all elements of the health system, to enable Aetna members to get the appropriate care when and where it is needed and wanted, in a culturally and linguistically appropriate manner.
  • Quality and safety. Quality and safety will be a focus of care, including the use of evidence-based medicine, clinical decision support tools and accountability for continuous quality improvement.
  • Enhanced access to care. Care will be available through systems such as open scheduling, expanded hours and new options for communication between Aetna members, their personal physicians and hospital staff.

The oncology medical home arrangement launched in September 2016.

About RCCA

Regional Cancer Care Associates (RCCA), one of the largest oncology physician networks in the United States, is transforming oncology care by ensuring that cancer patients have access to the highest-quality, most-comprehensive, cutting edge treatments in a compassionate and community-based setting. RCCA includes 100 cancer care specialists and is supported by 700 employees at 27 care delivery sites, providing care to more than 23,000 new patients annually and over 230,000 existing patients in New Jersey, Maryland and Washington DC. For more information visit: http://www.RCCA.com.

About Aetna

Aetna is one of the nation’s leading diversified health care benefits companies, serving an estimated 46.3 million people with information and resources to help them make better informed decisions about their health care. Aetna offers a broad range of traditional, voluntary and consumer-directed health insurance products and related services, including medical, pharmacy, dental, behavioral health, group life and disability plans, and medical management capabilities, Medicaid health care management services, workers’ compensation administrative services and health information technology products and services. Aetna’s customers include employer groups, individuals, college students, part-time and hourly workers, health plans, health care providers, governmental units, government-sponsored plans, labor groups and expatriates. For more information, see www.aetna.com and learn about how Aetna is helping to build a healthier world. @AetnaNews

 

###

What Cancer Patients Need To Know About Clinical Trials: Insights From New Jersey Hematologist /Oncologist Seth Berk

Seth Howard Berk, MD, a hematologist and medical oncologist with RCCA, reveals four facts that he shares with his patients when they ask about clinical trials.

First, a drug has been thoroughly tested well before it reaches the clinical trial stage. Pre-clinical trial testing involves looking at a drug’s effects on animals as well as human cells. This stage usually takes years of development. Also, the clinical studies have to be designed and conducted in accordance with rigorous ethical and safety criteria.

He also imparts the importance of not thinking of clinical trials as a last resort in treatment. While trials are typically suited for situations in which traditional therapy methods are not working for a patient, there is more evidence emerging of late-stage trials benefitting the patient when used early in the diagnosis process.

A myth that Dr. Berk debunks is the use of a placebo in cancer treatment. Some cancer patients are resistant to clinical trials because they fear there will be a placebo and they will suffer as a result. He says this is misinformation or something assumed from a patient’s memory of high school or college science experiments. In clinical trials, one group will be administered the trial agent while the other continues to have traditional therapy. There are rarely ever patients receiving zero care.

Lastly, Dr. Berk addresses the importance of clinical trials for cancer patients in general. Because of willing patients participating in more and more trials, doctors and patients can share in a community of knowledge and understanding, and, one day, a cure.

To read more about clinical trials, turn to “What cancer patients need to know about clinical trials: Insights from New Jersey oncologist/hematologist Seth Berk.”

RCCA: Taking Cancer Care To A Higher Level In NJ And Beyond

Edward J. Licitra, MD, PhD, board certified in internal medicine, hematology and medical oncology and chairman of the board of directors of Regional Cancer Care Associates (RCCA), shares some of his thoughts on potential models for a health care delivery reform system. Oncologists at RCCA, totaling 100 physicians, learn from each other’s best practices with the patient’s interest at the forefront. Through RCCA, patients can receive care at home instead of visiting a hospital or clinic. They have set up 27 care delivery sites, providing care to more than 23,000 new patients annually and approximately 230,000 existing patients in New Jersey, Maryland and Washington, D.C.

Another example of a successful care reform case is the Oncology Care Model (OCM) created by Medicare under the Affordable Care Act (ACA). The model questions how to best develop an integrated style of cancer care. It focuses on developing a care model for the future, using data sharing and streamlining economics for patients as well as providers. By digitizing patients’ medical histories and sharing them through hospitals and clinics, this model focuses on simplifying the oncology care process.

Lastly, the OCM utilizes evidence-based-medicine (EBM) practices throughout the entire spectrum of care. EBM produces the best methods regardless of cost, while even reducing cost by eliminating wasteful spending. The OCM focuses on patient-focused, research based therapy tailored to the individual patient.

To learn more about this topic, read “RCCA: Taking cancer care to a higher level in NJ and beyond.”

Targeting Treatments for Chronic Lymphocytic Leukemia

Dr. Joel Silver

 

How do myeloma and chronic lymphocytic leukemia (CLL) develop? What are some risk factors associated with those malignancies?

A. We don’t know what causes CLL. We do know that people in some occupations or with a certain exposure history might be at higher risk, and that CLL generally affects older people. Treatment fortunately is not needed in many cases, but even so our treatment options have evolved based on cytogenetics and next-generation sequencing. We have more ways to assess prognostic features and design more personalized and potentially more effective therapy for people with CLL.

 

What therapies have been successful in treating CLL over the last two to three years?

A. If you can identify a certain kind of CLL, such as IDH-mutated CLL, some of the patients with it can receive a standard chemotherapy regimen called FCR, and they sometimes go into remission indefinitely. It depends on whether the patient is young and healthy enough to tolerate the therapy. That’s a select group, though; you don’t see too many young people with CLL.

Years ago, an effective treatment did not exist for another group of patients with CLL, those with the genetic 17p deletion. In recent years, however, the oral agent ibrutinib has shown effectiveness for CLL in this group. Other therapies now are available for patients who don’t respond to ibrutinib.

 

Where does targeted therapy come into play?

A. In general, “targeted therapy” refers to a treatment based on a particular mutation or pattern. The presence of the genetic 17p deletion in CLL is one example, but this is a bad cytogenetic abnormality for which standard treatments such as chemotherapy haven’t worked. If we can identify a particular mutation, then we can target our therapy and plan treatment that we know will work, instead of going through chemotherapies that are only partially effective or downright ineffective and then finding that the patient is resistant to treatment.

 

Are there side effects or drawbacks to targeted therapy?

A. Everything we do has side effects. The oral agent ibrutinib has been an effective first-line therapy for any type of CLL. Although the agent is specifically for patients with 17p deletion, it has also worked for patients without that genetic feature. While some cardiovascular and bleeding issues have been reported, ibrutinib overall is more tolerable than chemotherapy.

When we medically examine patients with CLL, we always look at a pattern of mutations to try to identify how to treat these people — not so much from an immediate therapeutic standpoint, but to gain knowledge of all these other cytogenetic abnormalities so that eventually, we will find other ways to target those different patterns.

What important points do you address with patients before they begin CLL therapy?

A. Many people with CLL don’t die of their disease, they die with their disease, so I tell patients not to be afraid of the disease itself. Many of the conversations we have with these people, however, revolve around the fact that they have this problem but may never need treatment. “We should follow you because you may need treatment down the line,” I tell them. “If you need treatment, we have many effective therapies.”

 

Do you foresee different therapies for CLL emerging within the next two to three years?

A. A number of medications are on the horizon that will be appropriate for any patient with CLL. For example, venetoclax, which gained FDA approval last year, is indicated for second-line treatment of CLL in patients with the 17p deletion, but I think that agent will be effective for all patients with CLL. As similarly versatile agents are developed, we will have many more treatment options.

Colorectal Cancer Trends in Maryland: A Conversation with Dr. Ralph V. Boccia

As the third most common cancer in the United States, colorectal cancer (CRC) affects about 1 in 20 Americans. However, incidence and death rates for cancer of the colorectum have significantly decreased over the past several decades as a result of increased screening and drastic improvements in treatment. In Maryland alone, approximately 70% of adults over the age of 50 have an up-to-date colorectal cancer screening, helping contribute to the reduction in mortality rates.

Dr. Ralph V. Boccia, an oncology and hematology specialist at Regional Cancer Care Associates (RCCA) in Bethesda and Germantown, Maryland says, “The more colorectal screening we have and the earlier it gets started, the lower the stage that the cancer is typically picked up.” In turn, early detection has led to the state’s lower mortality rates over time.

 

The Benefits Of Increased Screening

According to Dr. Boccia, improving screening rates “affects the stage at which the cancer presents itself and [the patient’s] potential for survival.” Between 2002 and 2010, the percentage of Maryland adults with up-to-date colorectal cancer screenings increased from 64% to 71%. As a result, CRC mortality rates in Maryland decreased considerably among both men and women in that eight-year timeframe. Dr. Boccia explains, “The trend we’ve actually seen – which is that more people are being screened – has resulted in more improvements of overall survival in patients with colorectal cancer.”

However, as colon cancer rates decline in adults 50 years and older, both incidence and death rates are increasing in the under-50 population. “We’re seeing a scary trend of younger patients getting colorectal cancer,” remarks Dr. Boccia, “even down into the 20s.” However, at this point in time, there’s insufficient data to clearly identify the causation behind this trend.

 

Colorectal Cancer Risk Factors

According to a report from the Maryland Department of Health and Mental Hygiene, the incidence rate of colon cancer per 100,000 people in Maryland was 1,174 for men and 1,109 for women in 2012. When looking at new cases of CRC, research shows that incidence may be tied to habits and lifestyles. Among these lifestyle- associated risk factors are being overweight or obese, lack of physical activity, smoking, heavy alcohol use and certain types of diets.

As outlined by the American Cancer Society, other risk factors unrelated to lifestyle choices are personal and family histories of colorectal cancer or adenomatous polyps, having type 2 diabetes, possessing an inherited syndrome, such as Lynch Syndrome, and certain racial and ethnic backgrounds. In addition, Dr. Boccia notes that a personal history of inflammatory bowel disease may increase the risk for developing colorectal cancer. “Patients with ulcerative colitis have to be screened very frequently for colon cancer,” Dr. Boccia elucidates, “because of that high predisposition.”

 

Common CRC Treatments

“For early stage colorectal cancer, the treatment of choice is surgery,” says Dr. Boccia. In this stage, a group of abnormal cells, referred to as carcinoma in situ (CIS), can be removed by a polypectomy, or a part of the colon can be removed via a partial colectomy. Once the cancer has penetrated the wall of the colon and perhaps even grown into nearby tissue, patients of RCCA Maryland will typically undergo active surveillance – although other treatment options are offered to those with high-risk tumors, says Dr. Boccia.

Once the cancer has reached Stage III, patients are generally offered a form of chemotherapy for roughly six weeks. “FOLFOX is the adjuvant therapy of choice,” says Dr. Boccia, “and that we know will lower the incidence of recurrence by about 40-50%.” For Stage IV diseases, which make up about 20% of the cases that RCCA Maryland sees each year, chemotherapy, targeted therapy and even immunotherapy can be used to offer aggressive treatment. If they no longer respond to a particular drug, patients will be introduced to a new regimen.

In regards to new research and treatment options, Dr. Boccia concludes, “I have 50 to 60 clinical trials open at all times in the center, so we’re always looking actively for good, cutting-edge therapies and offering those to our patients.”

 

If you or someone you love has been diagnosed with colorectal cancer, schedule an appointment at one of RCCA’s 29 locations in New Jersey, Maryland or Connecticut for personalized, professional care.

Molecular Testing: Tailoring Treatment by Targeting Pathways

Phillip D. Reid, MD

 

What is molecular testing? How it is used in cancer care?

A.  As we learn how to treat specific subtypes of cancer more accurately, molecular testing, molecular medicine and molecular diagnostics are becoming more prominent in oncology.

In the past, once a cancer was diagnosed, we determined the organ where it started, how much cancer was in the body and where it was. We have since discovered many pathways through which a cancer develops. We now need to know not only the stage, type and origin of cancer, but also the pathway through which it developed and then target that pathway.

 

How does the pathway concept affect therapy selection?

A.  It enhances our ability to treat the cancer, but we now need extra testing on a patient’s particular cancer cells. The great thing about molecular testing is we get an answer specific for the individual, not just for everyone, for example, with lung cancer. But it does require more time for us to find the pathway. From the patient’s standpoint, diagnosis and stage are obtained, and then sometimes we have to send off the cancer cells for extra testing, which increases the time between diagnosis and treatment. But ultimately, a better sense is provided of what drug to use and when to use it, and there’s a much greater likelihood of devising specific, effective treatment.

 

For which types of cancer should molecular testing be used?

A.  Molecular testing has revolutionized every major cancer diagnosis. Patients with lung and breast cancer are the best candidates, but molecular testing also is useful in colon cancer, head-and-neck and bladder cancer, and some leukemias and myelomas.

 

What have been the main developments over the last two to three years with molecular testing?

A.  It’s becoming easier and more standardized to get molecular testing done. A patient receives a diagnosis and his or her cancer is sent off to a lab, which evaluates all known pathways for that cancer. A specific result is received. As the patient receives therapy, sometimes the cancer changes and he or she may need a second or third biopsy one to three years after the initial diagnosis to see what’s changed in the cancer, and then the treatment changes based on that result. We now see cancer as a moving target as it progresses, and we have to recalibrate every few years so that we’re shooting that target correctly.

 

What should patients know about molecular testing before proceeding?

A.  After a patient receives his or her staging diagnosis, the next question is, “What subtype of lung cancer do I have and what pathway did the cancer use to develop?” The patient needs to have patience, as that extra information may not arrive for two to four weeks, but that information can increase the chances of treatment success.

Also ask about clinical trials of cancer medications before beginning therapy, because we often know about upcoming medications that are effective and possibly better than what we have right now.

Colorectal Cancer Trends and Treatment

Ralph V. Boccia, MD, a cancer specialist at RCCA Maryland, provides some insight into recent colorectal cancer trends and treatments that are giving new hope to doctors, researchers and patients nationwide. Overall, Dr. Boccia finds much to be encouraged by, but also points to the need for awareness of a concerning development in the field of colorectal cancer.

 

How Far We’ve Come and Where We’re Going

As a whole, colorectal cancer rates have been dropping. According to the National Cancer Institute and Centers for Disease Control and Prevention, Maryland alone has seen a 2.6% decrease in the amount of new CRC patients diagnosed over a five-year period. Dr. Boccia believes this trend can be partly attributed to the following:

  • Widespread increase in colonoscopies and other CRC screening methods
  • Early detection and removal of polyps before they become cancerous
  • More cases being diagnosed at an early stage – when the cancer is more responsive to treatment

Despite the good news, it’s still projected that 2,358 Maryland residents will be diagnosed and that 927 people will die from the disease this year, says Dr. Boccia. Doctors have also been noticing an uncharacteristic increase in the amount of younger adults being diagnosed with CRC. Since it typically affects individuals above the age of 50, this emerging demographic has been cause for concern. But Dr. Boccia and his colleagues will continue to conduct research and make further strides in colorectal cancer care to better serve patients of all ages.

 

Current Treatment Options

Surgical innovations, targeted therapies, immunotherapies, chemotherapy and clinical trials are paving the way for more effective CRC solutions. Dr. Boccia explains, “We have a greater ability than ever before to individualize care, and to offer patients multi-modal treatment regimens that employ a variety of mechanisms of action to combat cancer by different means.”

 

Reducing Your Risk

Follow these tips to help reduce your risk for developing colorectal cancer:

  • Maintain a healthy weight
  • Stay physically active
  • Avoid smoking cigarettes and only drink alcohol in moderation
  • Get a CRC screening regularly
  • Consult a physician right away if you experience any CRC symptoms, such as blood in the stool and persistent abdominal pain
  • Manage other conditions that may increase your risk for CRC, like type 2 diabetes, inflammatory bowel disease and adenomatous polyps

 

If you or someone you love has been diagnosed with colorectal cancer, schedule an appointment at one of RCCA’s 29 locations in New Jersey, Maryland or Connecticut for personalized, professional care.

RCCA Earns URAC Accreditation In Specialty Pharmacy

[Hackensack, NJ] – RCCA is proud to announce that it has earned URAC accreditation in Specialty Pharmacy. URAC is the independent leader in promoting healthcare quality through accreditation, certification and measurement. By achieving this status, RCCA has demonstrated a comprehensive commitment to quality care, improved processes and better patient outcomes.

 

“URAC Accreditation is a testament to the commitment of delivering the highest level of quality standards to our patients and their caregivers,” said Terrill Jordan, President and CEO of RCCA. ”This type of commitment is the cornerstone of everything we do at RCCA,” he added.

Edward Licitra, MD, PhD, RCCA Chairperson of the Board and RCCA Pharmacy Medical Director and Eileen Peng, PharmD, Director of the RCCA Pharmacy agree that “this new recognition will allow us to continue to provide the highest level of patient care and convenience for the people that need it the most.”

 

“Pharmacy services have never played such an important role in the delivery of care as they do today. RCCA distinguishes itself for having voluntarily undergone a rigorous review of quality standards that earned it URAC accreditation,” said URAC President and CEO Kylanne Green. “Independent URAC accreditation shows RCCA is dedicated to quality and safety, and that it strives for a continual improvement of its services.”

ABOUT RCCA

Regional Cancer Care Associates (RCCA), one of the largest oncology physician networks in the United States, is transforming oncology care by ensuring that cancer patients have access to the highest-quality, most-comprehensive, cutting edge treatments in a compassionate and community-based setting. RCCA includes more than 100 cancer care specialists and is supported by 800 employees at more than 30 care delivery sites, providing care to more than 24,000 new patients annually and over 240,000 existing patients.  For more information visit: http://www.RCCA.com

About URAC

Founded in 1990, URAC is the independent leader in promoting healthcare quality through accreditation, certification and measurement. URAC is a nonprofit organization developing evidence-based measures and standards through inclusive engagement with a range of stakeholders committed to improving the quality of healthcare. Our portfolio of accreditation and certification programs span the healthcare industry, addressing healthcare management, healthcare operations, health plans, pharmacies, telehealth providers, physician practices, and more. URAC accreditation is a symbol of excellence for organizations to showcase their validated commitment to quality and accountability.

For further information, contact:

Mary Lou Salvemini
msalvemini@regionalcancercare.org
(201) 510-0922

RCCA Makes Innovative UnitedHealthcare Cancer Care Program Available to Patients in Maryland

HACKENSACK, N.J., Nov. 22, 2016 /PRNewswire-USNewswire/ — Regional Cancer Care Associates (RCCA) is expanding its cancer care payment initiative with UnitedHealthcare to RCCA patients in Maryland who are covered by UnitedHealthcare benefit plans.

The program, made available at RCCA New Jersey locations in January, rewards physicians for focusing on best treatment practices, quality patient care and better health outcomes. The program pays participating medical oncologists more if they demonstrate superior clinical results and if they reduce the total cost of care.

The episode payment model shifts reimbursement away from the current “fee-for-service” approach that emphasizes volume of care delivered regardless of a patient’s health outcomes. The episode payment is based on the expected cost of a standard treatment regimen for a specific condition, as predetermined by the doctor. Similar payment models have been shown to enhance care coordination and improve health outcomes for patients, while reducing overall costs.

“RCCA has emerged as a leader in delivering the highest-level quality cancer care to our patients,” said Terrill Jordan, RCCA President and CEO. “New payment methodologies like this put patients’ interests at the forefront of cancer treatment. It also results in significant cost savings, which advances efforts across the country to assist in controlling rising health care costs. We are excited to offer this program to our Maryland patient base.”

Lee N. Newcomer, M.D., UnitedHealthcare’s Senior Vice President, Oncology, said: “Our partnership with RCCA marks an important step toward expanded episode payment models and away from the traditional fee-for-service payments for oncology care. We look forward to working with RCCA and others to expand our efforts to identify best practices for treating cancer.”

A study published in the Journal of Oncology Practice has demonstrated that this program reduced overall cancer expenses by more than a third while improving quality outcomes. RCCA is among five oncology practices that have joined the program, which now has a total of more than 650 oncologists. RCCA in New Jersey and now Maryland comprise approximately 100 of these oncologists.

“Value-based cancer care is here. This program will enable Maryland-based RCCA oncologists to continue to provide patient-centered care at the highest level of quality,” said Ralph Boccia, M.D., RCCA Research Deputy Chair and Oncologist in Bethesda and Germantown, Md.

UnitedHealthcare first implemented its episode payment program as a pilot study between October 2009 and December 2012. The pilot study produced a significant reduction in hospitalizations and a 34 percent reduction in total costs while improving quality. Click here to read results of the study.

About RCCA
Regional Cancer Care Associates (RCCA), one of the largest oncology physician networks in the United States, is transforming oncology care by ensuring that cancer patients have access to the highest-quality, most-comprehensive, cutting edge treatments in a compassionate and community-based setting. RCCA includes 100 cancer care specialists and is supported by 700 employees at 27 care delivery sites, providing care to more than 230,000 existing patients in New Jersey, Maryland and Washington DC.  For more information visit: http://www.RCCA.com

Contact:

Mary Lou Salvemini
msalvemini@regionalcancercare.org
(201) 510-0922

REGIONAL CANCER CARE ASSOCIATES AND AETNA FORM ONCOLOGY MEDICAL HOME

REGIONAL CANCER CARE ASSOCIATES AND AETNA FORM ONCOLOGY MEDICAL HOME

— The Patient-Focused Model Supports High-Value Care–

 

Hackensack, NJ, October 12, 2016 — Regional Cancer Care Associates (RCCA) and Aetna (NYSE: AET) announced a collaboration to create an oncology medical home that is designed to improve the care experience for cancer patients.

In the oncology medical home model, teams of cancer specialists collectively provide a patient’s health care when he or she has a cancer diagnosis. The model will give RCCA the responsibility to arrange appropriate care that is continuous and proactive and physicians will be incentivized for improved health, affordability and a better patient experience.

The oncology medical home arrangement will be available to patients at all RCCA locations in New Jersey and Maryland.

“RCCA is excited to partner with Aetna on this program. It aligns with our vision of providing patient centered care close to home,” said Terrill Jordan, RCCA President & CEO. “This partnership will not only enable us to continue the delivery of high quality care through reduced side effects, but will also facilitate cost effective care based on the data Aetna will be sharing,” said Michael Ruiz de Somocurcio, RCCA Vice President of Payer and Provider Collaboration.

The model is part of a strategic direction to transition from fee-for-service medicine to value-based payment. Value-based arrangements are emerging as a solution to address rising health care costs, clinical inefficiency, duplication of services, and access to care. In value-based models, doctors and hospitals are paid for helping to keep people healthy and for improving the health of those who have chronic conditions in an evidence-based, cost-effective way.

“We understand that cancer treatment can be the hardest experience that our members will ever have to go through,” said Daniel Knecht, M.D., M.B.A., Aetna’s Head of Strategy & Planning and Interim Head of Oncology Solutions. “This oncology medical home with RCCA will help provide our members with high-quality care and an optimal patient experience.”

The operating principles of the RCCA and Aetna oncology medical home include:

  • An orientation to the whole person. A personal physician from RCCA will be responsible for providing or arranging all of a patient’s health care needs with other qualified professionals. This includes care for all stages of treatment: preventive services, acute care, chronic care, palliative care and end-of-life care.
  • Evidence-based, personalized medical care. The RCCA team will focus on making treatment decisions based on current medical evidence for each unique disease presentation, patient-specific factors and patient choice using appropriate treatments to improve quality and outcomes.
  • Coordinated and integrated care. Care will be facilitated, across all elements of the health system, to enable Aetna members to get the appropriate care when and where it is needed and wanted, in a culturally and linguistically appropriate manner.
  • Quality and safety. Quality and safety will be a focus of care, including the use of evidence-based medicine, clinical decision support tools and accountability for continuous quality improvement.
  • Enhanced access to care. Care will be available through systems such as open scheduling, expanded hours and new options for communication between Aetna members, their personal physicians and hospital staff.

The oncology medical home arrangement launched in September 2016.

About RCCA

Regional Cancer Care Associates (RCCA), one of the largest oncology physician networks in the United States, is transforming oncology care by ensuring that cancer patients have access to the highest-quality, most-comprehensive, cutting edge treatments in a compassionate and community-based setting. RCCA includes 100 cancer care specialists and is supported by 700 employees at 27 care delivery sites, providing care to more than 23,000 new patients annually and over 230,000 existing patients in New Jersey, Maryland and Washington DC. For more information visit: http://www.RCCA.com.

About Aetna

Aetna is one of the nation’s leading diversified health care benefits companies, serving an estimated 46.3 million people with information and resources to help them make better informed decisions about their health care. Aetna offers a broad range of traditional, voluntary and consumer-directed health insurance products and related services, including medical, pharmacy, dental, behavioral health, group life and disability plans, and medical management capabilities, Medicaid health care management services, workers’ compensation administrative services and health information technology products and services. Aetna’s customers include employer groups, individuals, college students, part-time and hourly workers, health plans, health care providers, governmental units, government-sponsored plans, labor groups and expatriates. For more information, see www.aetna.com and learn about how Aetna is helping to build a healthier world. @AetnaNews

 

###

What Cancer Patients Need To Know About Clinical Trials: Insights From New Jersey Hematologist /Oncologist Seth Berk

Seth Howard Berk, MD, a hematologist and medical oncologist with RCCA, reveals four facts that he shares with his patients when they ask about clinical trials.

First, a drug has been thoroughly tested well before it reaches the clinical trial stage. Pre-clinical trial testing involves looking at a drug’s effects on animals as well as human cells. This stage usually takes years of development. Also, the clinical studies have to be designed and conducted in accordance with rigorous ethical and safety criteria.

He also imparts the importance of not thinking of clinical trials as a last resort in treatment. While trials are typically suited for situations in which traditional therapy methods are not working for a patient, there is more evidence emerging of late-stage trials benefitting the patient when used early in the diagnosis process.

A myth that Dr. Berk debunks is the use of a placebo in cancer treatment. Some cancer patients are resistant to clinical trials because they fear there will be a placebo and they will suffer as a result. He says this is misinformation or something assumed from a patient’s memory of high school or college science experiments. In clinical trials, one group will be administered the trial agent while the other continues to have traditional therapy. There are rarely ever patients receiving zero care.

Lastly, Dr. Berk addresses the importance of clinical trials for cancer patients in general. Because of willing patients participating in more and more trials, doctors and patients can share in a community of knowledge and understanding, and, one day, a cure.

To read more about clinical trials, turn to “What cancer patients need to know about clinical trials: Insights from New Jersey oncologist/hematologist Seth Berk.”

RCCA: Taking Cancer Care To A Higher Level In NJ And Beyond

Edward J. Licitra, MD, PhD, board certified in internal medicine, hematology and medical oncology and chairman of the board of directors of Regional Cancer Care Associates (RCCA), shares some of his thoughts on potential models for a health care delivery reform system. Oncologists at RCCA, totaling 100 physicians, learn from each other’s best practices with the patient’s interest at the forefront. Through RCCA, patients can receive care at home instead of visiting a hospital or clinic. They have set up 27 care delivery sites, providing care to more than 23,000 new patients annually and approximately 230,000 existing patients in New Jersey, Maryland and Washington, D.C.

Another example of a successful care reform case is the Oncology Care Model (OCM) created by Medicare under the Affordable Care Act (ACA). The model questions how to best develop an integrated style of cancer care. It focuses on developing a care model for the future, using data sharing and streamlining economics for patients as well as providers. By digitizing patients’ medical histories and sharing them through hospitals and clinics, this model focuses on simplifying the oncology care process.

Lastly, the OCM utilizes evidence-based-medicine (EBM) practices throughout the entire spectrum of care. EBM produces the best methods regardless of cost, while even reducing cost by eliminating wasteful spending. The OCM focuses on patient-focused, research based therapy tailored to the individual patient.

To learn more about this topic, read “RCCA: Taking cancer care to a higher level in NJ and beyond.”

Targeting Treatments for Chronic Lymphocytic Leukemia

Dr. Joel Silver

 

How do myeloma and chronic lymphocytic leukemia (CLL) develop? What are some risk factors associated with those malignancies?

A. We don’t know what causes CLL. We do know that people in some occupations or with a certain exposure history might be at higher risk, and that CLL generally affects older people. Treatment fortunately is not needed in many cases, but even so our treatment options have evolved based on cytogenetics and next-generation sequencing. We have more ways to assess prognostic features and design more personalized and potentially more effective therapy for people with CLL.

 

What therapies have been successful in treating CLL over the last two to three years?

A. If you can identify a certain kind of CLL, such as IDH-mutated CLL, some of the patients with it can receive a standard chemotherapy regimen called FCR, and they sometimes go into remission indefinitely. It depends on whether the patient is young and healthy enough to tolerate the therapy. That’s a select group, though; you don’t see too many young people with CLL.

Years ago, an effective treatment did not exist for another group of patients with CLL, those with the genetic 17p deletion. In recent years, however, the oral agent ibrutinib has shown effectiveness for CLL in this group. Other therapies now are available for patients who don’t respond to ibrutinib.

 

Where does targeted therapy come into play?

A. In general, “targeted therapy” refers to a treatment based on a particular mutation or pattern. The presence of the genetic 17p deletion in CLL is one example, but this is a bad cytogenetic abnormality for which standard treatments such as chemotherapy haven’t worked. If we can identify a particular mutation, then we can target our therapy and plan treatment that we know will work, instead of going through chemotherapies that are only partially effective or downright ineffective and then finding that the patient is resistant to treatment.

 

Are there side effects or drawbacks to targeted therapy?

A. Everything we do has side effects. The oral agent ibrutinib has been an effective first-line therapy for any type of CLL. Although the agent is specifically for patients with 17p deletion, it has also worked for patients without that genetic feature. While some cardiovascular and bleeding issues have been reported, ibrutinib overall is more tolerable than chemotherapy.

When we medically examine patients with CLL, we always look at a pattern of mutations to try to identify how to treat these people — not so much from an immediate therapeutic standpoint, but to gain knowledge of all these other cytogenetic abnormalities so that eventually, we will find other ways to target those different patterns.

What important points do you address with patients before they begin CLL therapy?

A. Many people with CLL don’t die of their disease, they die with their disease, so I tell patients not to be afraid of the disease itself. Many of the conversations we have with these people, however, revolve around the fact that they have this problem but may never need treatment. “We should follow you because you may need treatment down the line,” I tell them. “If you need treatment, we have many effective therapies.”

 

Do you foresee different therapies for CLL emerging within the next two to three years?

A. A number of medications are on the horizon that will be appropriate for any patient with CLL. For example, venetoclax, which gained FDA approval last year, is indicated for second-line treatment of CLL in patients with the 17p deletion, but I think that agent will be effective for all patients with CLL. As similarly versatile agents are developed, we will have many more treatment options.

Colorectal Cancer Trends in Maryland: A Conversation with Dr. Ralph V. Boccia

As the third most common cancer in the United States, colorectal cancer (CRC) affects about 1 in 20 Americans. However, incidence and death rates for cancer of the colorectum have significantly decreased over the past several decades as a result of increased screening and drastic improvements in treatment. In Maryland alone, approximately 70% of adults over the age of 50 have an up-to-date colorectal cancer screening, helping contribute to the reduction in mortality rates.

Dr. Ralph V. Boccia, an oncology and hematology specialist at Regional Cancer Care Associates (RCCA) in Bethesda and Germantown, Maryland says, “The more colorectal screening we have and the earlier it gets started, the lower the stage that the cancer is typically picked up.” In turn, early detection has led to the state’s lower mortality rates over time.

 

The Benefits Of Increased Screening

According to Dr. Boccia, improving screening rates “affects the stage at which the cancer presents itself and [the patient’s] potential for survival.” Between 2002 and 2010, the percentage of Maryland adults with up-to-date colorectal cancer screenings increased from 64% to 71%. As a result, CRC mortality rates in Maryland decreased considerably among both men and women in that eight-year timeframe. Dr. Boccia explains, “The trend we’ve actually seen – which is that more people are being screened – has resulted in more improvements of overall survival in patients with colorectal cancer.”

However, as colon cancer rates decline in adults 50 years and older, both incidence and death rates are increasing in the under-50 population. “We’re seeing a scary trend of younger patients getting colorectal cancer,” remarks Dr. Boccia, “even down into the 20s.” However, at this point in time, there’s insufficient data to clearly identify the causation behind this trend.

 

Colorectal Cancer Risk Factors

According to a report from the Maryland Department of Health and Mental Hygiene, the incidence rate of colon cancer per 100,000 people in Maryland was 1,174 for men and 1,109 for women in 2012. When looking at new cases of CRC, research shows that incidence may be tied to habits and lifestyles. Among these lifestyle- associated risk factors are being overweight or obese, lack of physical activity, smoking, heavy alcohol use and certain types of diets.

As outlined by the American Cancer Society, other risk factors unrelated to lifestyle choices are personal and family histories of colorectal cancer or adenomatous polyps, having type 2 diabetes, possessing an inherited syndrome, such as Lynch Syndrome, and certain racial and ethnic backgrounds. In addition, Dr. Boccia notes that a personal history of inflammatory bowel disease may increase the risk for developing colorectal cancer. “Patients with ulcerative colitis have to be screened very frequently for colon cancer,” Dr. Boccia elucidates, “because of that high predisposition.”

 

Common CRC Treatments

“For early stage colorectal cancer, the treatment of choice is surgery,” says Dr. Boccia. In this stage, a group of abnormal cells, referred to as carcinoma in situ (CIS), can be removed by a polypectomy, or a part of the colon can be removed via a partial colectomy. Once the cancer has penetrated the wall of the colon and perhaps even grown into nearby tissue, patients of RCCA Maryland will typically undergo active surveillance – although other treatment options are offered to those with high-risk tumors, says Dr. Boccia.

Once the cancer has reached Stage III, patients are generally offered a form of chemotherapy for roughly six weeks. “FOLFOX is the adjuvant therapy of choice,” says Dr. Boccia, “and that we know will lower the incidence of recurrence by about 40-50%.” For Stage IV diseases, which make up about 20% of the cases that RCCA Maryland sees each year, chemotherapy, targeted therapy and even immunotherapy can be used to offer aggressive treatment. If they no longer respond to a particular drug, patients will be introduced to a new regimen.

In regards to new research and treatment options, Dr. Boccia concludes, “I have 50 to 60 clinical trials open at all times in the center, so we’re always looking actively for good, cutting-edge therapies and offering those to our patients.”

 

If you or someone you love has been diagnosed with colorectal cancer, schedule an appointment at one of RCCA’s 29 locations in New Jersey, Maryland or Connecticut for personalized, professional care.

Molecular Testing: Tailoring Treatment by Targeting Pathways

Phillip D. Reid, MD

 

What is molecular testing? How it is used in cancer care?

A.  As we learn how to treat specific subtypes of cancer more accurately, molecular testing, molecular medicine and molecular diagnostics are becoming more prominent in oncology.

In the past, once a cancer was diagnosed, we determined the organ where it started, how much cancer was in the body and where it was. We have since discovered many pathways through which a cancer develops. We now need to know not only the stage, type and origin of cancer, but also the pathway through which it developed and then target that pathway.

 

How does the pathway concept affect therapy selection?

A.  It enhances our ability to treat the cancer, but we now need extra testing on a patient’s particular cancer cells. The great thing about molecular testing is we get an answer specific for the individual, not just for everyone, for example, with lung cancer. But it does require more time for us to find the pathway. From the patient’s standpoint, diagnosis and stage are obtained, and then sometimes we have to send off the cancer cells for extra testing, which increases the time between diagnosis and treatment. But ultimately, a better sense is provided of what drug to use and when to use it, and there’s a much greater likelihood of devising specific, effective treatment.

 

For which types of cancer should molecular testing be used?

A.  Molecular testing has revolutionized every major cancer diagnosis. Patients with lung and breast cancer are the best candidates, but molecular testing also is useful in colon cancer, head-and-neck and bladder cancer, and some leukemias and myelomas.

 

What have been the main developments over the last two to three years with molecular testing?

A.  It’s becoming easier and more standardized to get molecular testing done. A patient receives a diagnosis and his or her cancer is sent off to a lab, which evaluates all known pathways for that cancer. A specific result is received. As the patient receives therapy, sometimes the cancer changes and he or she may need a second or third biopsy one to three years after the initial diagnosis to see what’s changed in the cancer, and then the treatment changes based on that result. We now see cancer as a moving target as it progresses, and we have to recalibrate every few years so that we’re shooting that target correctly.

 

What should patients know about molecular testing before proceeding?

A.  After a patient receives his or her staging diagnosis, the next question is, “What subtype of lung cancer do I have and what pathway did the cancer use to develop?” The patient needs to have patience, as that extra information may not arrive for two to four weeks, but that information can increase the chances of treatment success.

Also ask about clinical trials of cancer medications before beginning therapy, because we often know about upcoming medications that are effective and possibly better than what we have right now.

Colorectal Cancer Trends and Treatment

Ralph V. Boccia, MD, a cancer specialist at RCCA Maryland, provides some insight into recent colorectal cancer trends and treatments that are giving new hope to doctors, researchers and patients nationwide. Overall, Dr. Boccia finds much to be encouraged by, but also points to the need for awareness of a concerning development in the field of colorectal cancer.

 

How Far We’ve Come and Where We’re Going

As a whole, colorectal cancer rates have been dropping. According to the National Cancer Institute and Centers for Disease Control and Prevention, Maryland alone has seen a 2.6% decrease in the amount of new CRC patients diagnosed over a five-year period. Dr. Boccia believes this trend can be partly attributed to the following:

  • Widespread increase in colonoscopies and other CRC screening methods
  • Early detection and removal of polyps before they become cancerous
  • More cases being diagnosed at an early stage – when the cancer is more responsive to treatment

Despite the good news, it’s still projected that 2,358 Maryland residents will be diagnosed and that 927 people will die from the disease this year, says Dr. Boccia. Doctors have also been noticing an uncharacteristic increase in the amount of younger adults being diagnosed with CRC. Since it typically affects individuals above the age of 50, this emerging demographic has been cause for concern. But Dr. Boccia and his colleagues will continue to conduct research and make further strides in colorectal cancer care to better serve patients of all ages.

 

Current Treatment Options

Surgical innovations, targeted therapies, immunotherapies, chemotherapy and clinical trials are paving the way for more effective CRC solutions. Dr. Boccia explains, “We have a greater ability than ever before to individualize care, and to offer patients multi-modal treatment regimens that employ a variety of mechanisms of action to combat cancer by different means.”

 

Reducing Your Risk

Follow these tips to help reduce your risk for developing colorectal cancer:

  • Maintain a healthy weight
  • Stay physically active
  • Avoid smoking cigarettes and only drink alcohol in moderation
  • Get a CRC screening regularly
  • Consult a physician right away if you experience any CRC symptoms, such as blood in the stool and persistent abdominal pain
  • Manage other conditions that may increase your risk for CRC, like type 2 diabetes, inflammatory bowel disease and adenomatous polyps

 

If you or someone you love has been diagnosed with colorectal cancer, schedule an appointment at one of RCCA’s 29 locations in New Jersey, Maryland or Connecticut for personalized, professional care.

RCCA Earns URAC Accreditation In Specialty Pharmacy

[Hackensack, NJ] – RCCA is proud to announce that it has earned URAC accreditation in Specialty Pharmacy. URAC is the independent leader in promoting healthcare quality through accreditation, certification and measurement. By achieving this status, RCCA has demonstrated a comprehensive commitment to quality care, improved processes and better patient outcomes.

 

“URAC Accreditation is a testament to the commitment of delivering the highest level of quality standards to our patients and their caregivers,” said Terrill Jordan, President and CEO of RCCA. ”This type of commitment is the cornerstone of everything we do at RCCA,” he added.

Edward Licitra, MD, PhD, RCCA Chairperson of the Board and RCCA Pharmacy Medical Director and Eileen Peng, PharmD, Director of the RCCA Pharmacy agree that “this new recognition will allow us to continue to provide the highest level of patient care and convenience for the people that need it the most.”

 

“Pharmacy services have never played such an important role in the delivery of care as they do today. RCCA distinguishes itself for having voluntarily undergone a rigorous review of quality standards that earned it URAC accreditation,” said URAC President and CEO Kylanne Green. “Independent URAC accreditation shows RCCA is dedicated to quality and safety, and that it strives for a continual improvement of its services.”

ABOUT RCCA

Regional Cancer Care Associates (RCCA), one of the largest oncology physician networks in the United States, is transforming oncology care by ensuring that cancer patients have access to the highest-quality, most-comprehensive, cutting edge treatments in a compassionate and community-based setting. RCCA includes more than 100 cancer care specialists and is supported by 800 employees at more than 30 care delivery sites, providing care to more than 24,000 new patients annually and over 240,000 existing patients.  For more information visit: http://www.RCCA.com

About URAC

Founded in 1990, URAC is the independent leader in promoting healthcare quality through accreditation, certification and measurement. URAC is a nonprofit organization developing evidence-based measures and standards through inclusive engagement with a range of stakeholders committed to improving the quality of healthcare. Our portfolio of accreditation and certification programs span the healthcare industry, addressing healthcare management, healthcare operations, health plans, pharmacies, telehealth providers, physician practices, and more. URAC accreditation is a symbol of excellence for organizations to showcase their validated commitment to quality and accountability.

For further information, contact:

Mary Lou Salvemini
msalvemini@regionalcancercare.org
(201) 510-0922

RCCA Makes Innovative UnitedHealthcare Cancer Care Program Available to Patients in Maryland

HACKENSACK, N.J., Nov. 22, 2016 /PRNewswire-USNewswire/ — Regional Cancer Care Associates (RCCA) is expanding its cancer care payment initiative with UnitedHealthcare to RCCA patients in Maryland who are covered by UnitedHealthcare benefit plans.

The program, made available at RCCA New Jersey locations in January, rewards physicians for focusing on best treatment practices, quality patient care and better health outcomes. The program pays participating medical oncologists more if they demonstrate superior clinical results and if they reduce the total cost of care.

The episode payment model shifts reimbursement away from the current “fee-for-service” approach that emphasizes volume of care delivered regardless of a patient’s health outcomes. The episode payment is based on the expected cost of a standard treatment regimen for a specific condition, as predetermined by the doctor. Similar payment models have been shown to enhance care coordination and improve health outcomes for patients, while reducing overall costs.

“RCCA has emerged as a leader in delivering the highest-level quality cancer care to our patients,” said Terrill Jordan, RCCA President and CEO. “New payment methodologies like this put patients’ interests at the forefront of cancer treatment. It also results in significant cost savings, which advances efforts across the country to assist in controlling rising health care costs. We are excited to offer this program to our Maryland patient base.”

Lee N. Newcomer, M.D., UnitedHealthcare’s Senior Vice President, Oncology, said: “Our partnership with RCCA marks an important step toward expanded episode payment models and away from the traditional fee-for-service payments for oncology care. We look forward to working with RCCA and others to expand our efforts to identify best practices for treating cancer.”

A study published in the Journal of Oncology Practice has demonstrated that this program reduced overall cancer expenses by more than a third while improving quality outcomes. RCCA is among five oncology practices that have joined the program, which now has a total of more than 650 oncologists. RCCA in New Jersey and now Maryland comprise approximately 100 of these oncologists.

“Value-based cancer care is here. This program will enable Maryland-based RCCA oncologists to continue to provide patient-centered care at the highest level of quality,” said Ralph Boccia, M.D., RCCA Research Deputy Chair and Oncologist in Bethesda and Germantown, Md.

UnitedHealthcare first implemented its episode payment program as a pilot study between October 2009 and December 2012. The pilot study produced a significant reduction in hospitalizations and a 34 percent reduction in total costs while improving quality. Click here to read results of the study.

About RCCA
Regional Cancer Care Associates (RCCA), one of the largest oncology physician networks in the United States, is transforming oncology care by ensuring that cancer patients have access to the highest-quality, most-comprehensive, cutting edge treatments in a compassionate and community-based setting. RCCA includes 100 cancer care specialists and is supported by 700 employees at 27 care delivery sites, providing care to more than 230,000 existing patients in New Jersey, Maryland and Washington DC.  For more information visit: http://www.RCCA.com

Contact:

Mary Lou Salvemini
msalvemini@regionalcancercare.org
(201) 510-0922

REGIONAL CANCER CARE ASSOCIATES AND AETNA FORM ONCOLOGY MEDICAL HOME

REGIONAL CANCER CARE ASSOCIATES AND AETNA FORM ONCOLOGY MEDICAL HOME

— The Patient-Focused Model Supports High-Value Care–

 

Hackensack, NJ, October 12, 2016 — Regional Cancer Care Associates (RCCA) and Aetna (NYSE: AET) announced a collaboration to create an oncology medical home that is designed to improve the care experience for cancer patients.

In the oncology medical home model, teams of cancer specialists collectively provide a patient’s health care when he or she has a cancer diagnosis. The model will give RCCA the responsibility to arrange appropriate care that is continuous and proactive and physicians will be incentivized for improved health, affordability and a better patient experience.

The oncology medical home arrangement will be available to patients at all RCCA locations in New Jersey and Maryland.

“RCCA is excited to partner with Aetna on this program. It aligns with our vision of providing patient centered care close to home,” said Terrill Jordan, RCCA President & CEO. “This partnership will not only enable us to continue the delivery of high quality care through reduced side effects, but will also facilitate cost effective care based on the data Aetna will be sharing,” said Michael Ruiz de Somocurcio, RCCA Vice President of Payer and Provider Collaboration.

The model is part of a strategic direction to transition from fee-for-service medicine to value-based payment. Value-based arrangements are emerging as a solution to address rising health care costs, clinical inefficiency, duplication of services, and access to care. In value-based models, doctors and hospitals are paid for helping to keep people healthy and for improving the health of those who have chronic conditions in an evidence-based, cost-effective way.

“We understand that cancer treatment can be the hardest experience that our members will ever have to go through,” said Daniel Knecht, M.D., M.B.A., Aetna’s Head of Strategy & Planning and Interim Head of Oncology Solutions. “This oncology medical home with RCCA will help provide our members with high-quality care and an optimal patient experience.”

The operating principles of the RCCA and Aetna oncology medical home include:

  • An orientation to the whole person. A personal physician from RCCA will be responsible for providing or arranging all of a patient’s health care needs with other qualified professionals. This includes care for all stages of treatment: preventive services, acute care, chronic care, palliative care and end-of-life care.
  • Evidence-based, personalized medical care. The RCCA team will focus on making treatment decisions based on current medical evidence for each unique disease presentation, patient-specific factors and patient choice using appropriate treatments to improve quality and outcomes.
  • Coordinated and integrated care. Care will be facilitated, across all elements of the health system, to enable Aetna members to get the appropriate care when and where it is needed and wanted, in a culturally and linguistically appropriate manner.
  • Quality and safety. Quality and safety will be a focus of care, including the use of evidence-based medicine, clinical decision support tools and accountability for continuous quality improvement.
  • Enhanced access to care. Care will be available through systems such as open scheduling, expanded hours and new options for communication between Aetna members, their personal physicians and hospital staff.

The oncology medical home arrangement launched in September 2016.

About RCCA

Regional Cancer Care Associates (RCCA), one of the largest oncology physician networks in the United States, is transforming oncology care by ensuring that cancer patients have access to the highest-quality, most-comprehensive, cutting edge treatments in a compassionate and community-based setting. RCCA includes 100 cancer care specialists and is supported by 700 employees at 27 care delivery sites, providing care to more than 23,000 new patients annually and over 230,000 existing patients in New Jersey, Maryland and Washington DC. For more information visit: http://www.RCCA.com.

About Aetna

Aetna is one of the nation’s leading diversified health care benefits companies, serving an estimated 46.3 million people with information and resources to help them make better informed decisions about their health care. Aetna offers a broad range of traditional, voluntary and consumer-directed health insurance products and related services, including medical, pharmacy, dental, behavioral health, group life and disability plans, and medical management capabilities, Medicaid health care management services, workers’ compensation administrative services and health information technology products and services. Aetna’s customers include employer groups, individuals, college students, part-time and hourly workers, health plans, health care providers, governmental units, government-sponsored plans, labor groups and expatriates. For more information, see www.aetna.com and learn about how Aetna is helping to build a healthier world. @AetnaNews

 

###

What Cancer Patients Need To Know About Clinical Trials: Insights From New Jersey Hematologist /Oncologist Seth Berk

Seth Howard Berk, MD, a hematologist and medical oncologist with RCCA, reveals four facts that he shares with his patients when they ask about clinical trials.

First, a drug has been thoroughly tested well before it reaches the clinical trial stage. Pre-clinical trial testing involves looking at a drug’s effects on animals as well as human cells. This stage usually takes years of development. Also, the clinical studies have to be designed and conducted in accordance with rigorous ethical and safety criteria.

He also imparts the importance of not thinking of clinical trials as a last resort in treatment. While trials are typically suited for situations in which traditional therapy methods are not working for a patient, there is more evidence emerging of late-stage trials benefitting the patient when used early in the diagnosis process.

A myth that Dr. Berk debunks is the use of a placebo in cancer treatment. Some cancer patients are resistant to clinical trials because they fear there will be a placebo and they will suffer as a result. He says this is misinformation or something assumed from a patient’s memory of high school or college science experiments. In clinical trials, one group will be administered the trial agent while the other continues to have traditional therapy. There are rarely ever patients receiving zero care.

Lastly, Dr. Berk addresses the importance of clinical trials for cancer patients in general. Because of willing patients participating in more and more trials, doctors and patients can share in a community of knowledge and understanding, and, one day, a cure.

To read more about clinical trials, turn to “What cancer patients need to know about clinical trials: Insights from New Jersey oncologist/hematologist Seth Berk.”

RCCA: Taking Cancer Care To A Higher Level In NJ And Beyond

Edward J. Licitra, MD, PhD, board certified in internal medicine, hematology and medical oncology and chairman of the board of directors of Regional Cancer Care Associates (RCCA), shares some of his thoughts on potential models for a health care delivery reform system. Oncologists at RCCA, totaling 100 physicians, learn from each other’s best practices with the patient’s interest at the forefront. Through RCCA, patients can receive care at home instead of visiting a hospital or clinic. They have set up 27 care delivery sites, providing care to more than 23,000 new patients annually and approximately 230,000 existing patients in New Jersey, Maryland and Washington, D.C.

Another example of a successful care reform case is the Oncology Care Model (OCM) created by Medicare under the Affordable Care Act (ACA). The model questions how to best develop an integrated style of cancer care. It focuses on developing a care model for the future, using data sharing and streamlining economics for patients as well as providers. By digitizing patients’ medical histories and sharing them through hospitals and clinics, this model focuses on simplifying the oncology care process.

Lastly, the OCM utilizes evidence-based-medicine (EBM) practices throughout the entire spectrum of care. EBM produces the best methods regardless of cost, while even reducing cost by eliminating wasteful spending. The OCM focuses on patient-focused, research based therapy tailored to the individual patient.

To learn more about this topic, read “RCCA: Taking cancer care to a higher level in NJ and beyond.”

Targeting Treatments for Chronic Lymphocytic Leukemia

Dr. Joel Silver

 

How do myeloma and chronic lymphocytic leukemia (CLL) develop? What are some risk factors associated with those malignancies?

A. We don’t know what causes CLL. We do know that people in some occupations or with a certain exposure history might be at higher risk, and that CLL generally affects older people. Treatment fortunately is not needed in many cases, but even so our treatment options have evolved based on cytogenetics and next-generation sequencing. We have more ways to assess prognostic features and design more personalized and potentially more effective therapy for people with CLL.

 

What therapies have been successful in treating CLL over the last two to three years?

A. If you can identify a certain kind of CLL, such as IDH-mutated CLL, some of the patients with it can receive a standard chemotherapy regimen called FCR, and they sometimes go into remission indefinitely. It depends on whether the patient is young and healthy enough to tolerate the therapy. That’s a select group, though; you don’t see too many young people with CLL.

Years ago, an effective treatment did not exist for another group of patients with CLL, those with the genetic 17p deletion. In recent years, however, the oral agent ibrutinib has shown effectiveness for CLL in this group. Other therapies now are available for patients who don’t respond to ibrutinib.

 

Where does targeted therapy come into play?

A. In general, “targeted therapy” refers to a treatment based on a particular mutation or pattern. The presence of the genetic 17p deletion in CLL is one example, but this is a bad cytogenetic abnormality for which standard treatments such as chemotherapy haven’t worked. If we can identify a particular mutation, then we can target our therapy and plan treatment that we know will work, instead of going through chemotherapies that are only partially effective or downright ineffective and then finding that the patient is resistant to treatment.

 

Are there side effects or drawbacks to targeted therapy?

A. Everything we do has side effects. The oral agent ibrutinib has been an effective first-line therapy for any type of CLL. Although the agent is specifically for patients with 17p deletion, it has also worked for patients without that genetic feature. While some cardiovascular and bleeding issues have been reported, ibrutinib overall is more tolerable than chemotherapy.

When we medically examine patients with CLL, we always look at a pattern of mutations to try to identify how to treat these people — not so much from an immediate therapeutic standpoint, but to gain knowledge of all these other cytogenetic abnormalities so that eventually, we will find other ways to target those different patterns.

What important points do you address with patients before they begin CLL therapy?

A. Many people with CLL don’t die of their disease, they die with their disease, so I tell patients not to be afraid of the disease itself. Many of the conversations we have with these people, however, revolve around the fact that they have this problem but may never need treatment. “We should follow you because you may need treatment down the line,” I tell them. “If you need treatment, we have many effective therapies.”

 

Do you foresee different therapies for CLL emerging within the next two to three years?

A. A number of medications are on the horizon that will be appropriate for any patient with CLL. For example, venetoclax, which gained FDA approval last year, is indicated for second-line treatment of CLL in patients with the 17p deletion, but I think that agent will be effective for all patients with CLL. As similarly versatile agents are developed, we will have many more treatment options.

Colorectal Cancer Trends in Maryland: A Conversation with Dr. Ralph V. Boccia

As the third most common cancer in the United States, colorectal cancer (CRC) affects about 1 in 20 Americans. However, incidence and death rates for cancer of the colorectum have significantly decreased over the past several decades as a result of increased screening and drastic improvements in treatment. In Maryland alone, approximately 70% of adults over the age of 50 have an up-to-date colorectal cancer screening, helping contribute to the reduction in mortality rates.

Dr. Ralph V. Boccia, an oncology and hematology specialist at Regional Cancer Care Associates (RCCA) in Bethesda and Germantown, Maryland says, “The more colorectal screening we have and the earlier it gets started, the lower the stage that the cancer is typically picked up.” In turn, early detection has led to the state’s lower mortality rates over time.

 

The Benefits Of Increased Screening

According to Dr. Boccia, improving screening rates “affects the stage at which the cancer presents itself and [the patient’s] potential for survival.” Between 2002 and 2010, the percentage of Maryland adults with up-to-date colorectal cancer screenings increased from 64% to 71%. As a result, CRC mortality rates in Maryland decreased considerably among both men and women in that eight-year timeframe. Dr. Boccia explains, “The trend we’ve actually seen – which is that more people are being screened – has resulted in more improvements of overall survival in patients with colorectal cancer.”

However, as colon cancer rates decline in adults 50 years and older, both incidence and death rates are increasing in the under-50 population. “We’re seeing a scary trend of younger patients getting colorectal cancer,” remarks Dr. Boccia, “even down into the 20s.” However, at this point in time, there’s insufficient data to clearly identify the causation behind this trend.

 

Colorectal Cancer Risk Factors

According to a report from the Maryland Department of Health and Mental Hygiene, the incidence rate of colon cancer per 100,000 people in Maryland was 1,174 for men and 1,109 for women in 2012. When looking at new cases of CRC, research shows that incidence may be tied to habits and lifestyles. Among these lifestyle- associated risk factors are being overweight or obese, lack of physical activity, smoking, heavy alcohol use and certain types of diets.

As outlined by the American Cancer Society, other risk factors unrelated to lifestyle choices are personal and family histories of colorectal cancer or adenomatous polyps, having type 2 diabetes, possessing an inherited syndrome, such as Lynch Syndrome, and certain racial and ethnic backgrounds. In addition, Dr. Boccia notes that a personal history of inflammatory bowel disease may increase the risk for developing colorectal cancer. “Patients with ulcerative colitis have to be screened very frequently for colon cancer,” Dr. Boccia elucidates, “because of that high predisposition.”

 

Common CRC Treatments

“For early stage colorectal cancer, the treatment of choice is surgery,” says Dr. Boccia. In this stage, a group of abnormal cells, referred to as carcinoma in situ (CIS), can be removed by a polypectomy, or a part of the colon can be removed via a partial colectomy. Once the cancer has penetrated the wall of the colon and perhaps even grown into nearby tissue, patients of RCCA Maryland will typically undergo active surveillance – although other treatment options are offered to those with high-risk tumors, says Dr. Boccia.

Once the cancer has reached Stage III, patients are generally offered a form of chemotherapy for roughly six weeks. “FOLFOX is the adjuvant therapy of choice,” says Dr. Boccia, “and that we know will lower the incidence of recurrence by about 40-50%.” For Stage IV diseases, which make up about 20% of the cases that RCCA Maryland sees each year, chemotherapy, targeted therapy and even immunotherapy can be used to offer aggressive treatment. If they no longer respond to a particular drug, patients will be introduced to a new regimen.

In regards to new research and treatment options, Dr. Boccia concludes, “I have 50 to 60 clinical trials open at all times in the center, so we’re always looking actively for good, cutting-edge therapies and offering those to our patients.”

 

If you or someone you love has been diagnosed with colorectal cancer, schedule an appointment at one of RCCA’s 29 locations in New Jersey, Maryland or Connecticut for personalized, professional care.

Molecular Testing: Tailoring Treatment by Targeting Pathways

Phillip D. Reid, MD

 

What is molecular testing? How it is used in cancer care?

A.  As we learn how to treat specific subtypes of cancer more accurately, molecular testing, molecular medicine and molecular diagnostics are becoming more prominent in oncology.

In the past, once a cancer was diagnosed, we determined the organ where it started, how much cancer was in the body and where it was. We have since discovered many pathways through which a cancer develops. We now need to know not only the stage, type and origin of cancer, but also the pathway through which it developed and then target that pathway.

 

How does the pathway concept affect therapy selection?

A.  It enhances our ability to treat the cancer, but we now need extra testing on a patient’s particular cancer cells. The great thing about molecular testing is we get an answer specific for the individual, not just for everyone, for example, with lung cancer. But it does require more time for us to find the pathway. From the patient’s standpoint, diagnosis and stage are obtained, and then sometimes we have to send off the cancer cells for extra testing, which increases the time between diagnosis and treatment. But ultimately, a better sense is provided of what drug to use and when to use it, and there’s a much greater likelihood of devising specific, effective treatment.

 

For which types of cancer should molecular testing be used?

A.  Molecular testing has revolutionized every major cancer diagnosis. Patients with lung and breast cancer are the best candidates, but molecular testing also is useful in colon cancer, head-and-neck and bladder cancer, and some leukemias and myelomas.

 

What have been the main developments over the last two to three years with molecular testing?

A.  It’s becoming easier and more standardized to get molecular testing done. A patient receives a diagnosis and his or her cancer is sent off to a lab, which evaluates all known pathways for that cancer. A specific result is received. As the patient receives therapy, sometimes the cancer changes and he or she may need a second or third biopsy one to three years after the initial diagnosis to see what’s changed in the cancer, and then the treatment changes based on that result. We now see cancer as a moving target as it progresses, and we have to recalibrate every few years so that we’re shooting that target correctly.

 

What should patients know about molecular testing before proceeding?

A.  After a patient receives his or her staging diagnosis, the next question is, “What subtype of lung cancer do I have and what pathway did the cancer use to develop?” The patient needs to have patience, as that extra information may not arrive for two to four weeks, but that information can increase the chances of treatment success.

Also ask about clinical trials of cancer medications before beginning therapy, because we often know about upcoming medications that are effective and possibly better than what we have right now.

Colorectal Cancer Trends and Treatment

Ralph V. Boccia, MD, a cancer specialist at RCCA Maryland, provides some insight into recent colorectal cancer trends and treatments that are giving new hope to doctors, researchers and patients nationwide. Overall, Dr. Boccia finds much to be encouraged by, but also points to the need for awareness of a concerning development in the field of colorectal cancer.

 

How Far We’ve Come and Where We’re Going

As a whole, colorectal cancer rates have been dropping. According to the National Cancer Institute and Centers for Disease Control and Prevention, Maryland alone has seen a 2.6% decrease in the amount of new CRC patients diagnosed over a five-year period. Dr. Boccia believes this trend can be partly attributed to the following:

  • Widespread increase in colonoscopies and other CRC screening methods
  • Early detection and removal of polyps before they become cancerous
  • More cases being diagnosed at an early stage – when the cancer is more responsive to treatment

Despite the good news, it’s still projected that 2,358 Maryland residents will be diagnosed and that 927 people will die from the disease this year, says Dr. Boccia. Doctors have also been noticing an uncharacteristic increase in the amount of younger adults being diagnosed with CRC. Since it typically affects individuals above the age of 50, this emerging demographic has been cause for concern. But Dr. Boccia and his colleagues will continue to conduct research and make further strides in colorectal cancer care to better serve patients of all ages.

 

Current Treatment Options

Surgical innovations, targeted therapies, immunotherapies, chemotherapy and clinical trials are paving the way for more effective CRC solutions. Dr. Boccia explains, “We have a greater ability than ever before to individualize care, and to offer patients multi-modal treatment regimens that employ a variety of mechanisms of action to combat cancer by different means.”

 

Reducing Your Risk

Follow these tips to help reduce your risk for developing colorectal cancer:

  • Maintain a healthy weight
  • Stay physically active
  • Avoid smoking cigarettes and only drink alcohol in moderation
  • Get a CRC screening regularly
  • Consult a physician right away if you experience any CRC symptoms, such as blood in the stool and persistent abdominal pain
  • Manage other conditions that may increase your risk for CRC, like type 2 diabetes, inflammatory bowel disease and adenomatous polyps

 

If you or someone you love has been diagnosed with colorectal cancer, schedule an appointment at one of RCCA’s 29 locations in New Jersey, Maryland or Connecticut for personalized, professional care.

RCCA Earns URAC Accreditation In Specialty Pharmacy

[Hackensack, NJ] – RCCA is proud to announce that it has earned URAC accreditation in Specialty Pharmacy. URAC is the independent leader in promoting healthcare quality through accreditation, certification and measurement. By achieving this status, RCCA has demonstrated a comprehensive commitment to quality care, improved processes and better patient outcomes.

 

“URAC Accreditation is a testament to the commitment of delivering the highest level of quality standards to our patients and their caregivers,” said Terrill Jordan, President and CEO of RCCA. ”This type of commitment is the cornerstone of everything we do at RCCA,” he added.

Edward Licitra, MD, PhD, RCCA Chairperson of the Board and RCCA Pharmacy Medical Director and Eileen Peng, PharmD, Director of the RCCA Pharmacy agree that “this new recognition will allow us to continue to provide the highest level of patient care and convenience for the people that need it the most.”

 

“Pharmacy services have never played such an important role in the delivery of care as they do today. RCCA distinguishes itself for having voluntarily undergone a rigorous review of quality standards that earned it URAC accreditation,” said URAC President and CEO Kylanne Green. “Independent URAC accreditation shows RCCA is dedicated to quality and safety, and that it strives for a continual improvement of its services.”

ABOUT RCCA

Regional Cancer Care Associates (RCCA), one of the largest oncology physician networks in the United States, is transforming oncology care by ensuring that cancer patients have access to the highest-quality, most-comprehensive, cutting edge treatments in a compassionate and community-based setting. RCCA includes more than 100 cancer care specialists and is supported by 800 employees at more than 30 care delivery sites, providing care to more than 24,000 new patients annually and over 240,000 existing patients.  For more information visit: http://www.RCCA.com

About URAC

Founded in 1990, URAC is the independent leader in promoting healthcare quality through accreditation, certification and measurement. URAC is a nonprofit organization developing evidence-based measures and standards through inclusive engagement with a range of stakeholders committed to improving the quality of healthcare. Our portfolio of accreditation and certification programs span the healthcare industry, addressing healthcare management, healthcare operations, health plans, pharmacies, telehealth providers, physician practices, and more. URAC accreditation is a symbol of excellence for organizations to showcase their validated commitment to quality and accountability.

For further information, contact:

Mary Lou Salvemini
msalvemini@regionalcancercare.org
(201) 510-0922

RCCA Makes Innovative UnitedHealthcare Cancer Care Program Available to Patients in Maryland

HACKENSACK, N.J., Nov. 22, 2016 /PRNewswire-USNewswire/ — Regional Cancer Care Associates (RCCA) is expanding its cancer care payment initiative with UnitedHealthcare to RCCA patients in Maryland who are covered by UnitedHealthcare benefit plans.

The program, made available at RCCA New Jersey locations in January, rewards physicians for focusing on best treatment practices, quality patient care and better health outcomes. The program pays participating medical oncologists more if they demonstrate superior clinical results and if they reduce the total cost of care.

The episode payment model shifts reimbursement away from the current “fee-for-service” approach that emphasizes volume of care delivered regardless of a patient’s health outcomes. The episode payment is based on the expected cost of a standard treatment regimen for a specific condition, as predetermined by the doctor. Similar payment models have been shown to enhance care coordination and improve health outcomes for patients, while reducing overall costs.

“RCCA has emerged as a leader in delivering the highest-level quality cancer care to our patients,” said Terrill Jordan, RCCA President and CEO. “New payment methodologies like this put patients’ interests at the forefront of cancer treatment. It also results in significant cost savings, which advances efforts across the country to assist in controlling rising health care costs. We are excited to offer this program to our Maryland patient base.”

Lee N. Newcomer, M.D., UnitedHealthcare’s Senior Vice President, Oncology, said: “Our partnership with RCCA marks an important step toward expanded episode payment models and away from the traditional fee-for-service payments for oncology care. We look forward to working with RCCA and others to expand our efforts to identify best practices for treating cancer.”

A study published in the Journal of Oncology Practice has demonstrated that this program reduced overall cancer expenses by more than a third while improving quality outcomes. RCCA is among five oncology practices that have joined the program, which now has a total of more than 650 oncologists. RCCA in New Jersey and now Maryland comprise approximately 100 of these oncologists.

“Value-based cancer care is here. This program will enable Maryland-based RCCA oncologists to continue to provide patient-centered care at the highest level of quality,” said Ralph Boccia, M.D., RCCA Research Deputy Chair and Oncologist in Bethesda and Germantown, Md.

UnitedHealthcare first implemented its episode payment program as a pilot study between October 2009 and December 2012. The pilot study produced a significant reduction in hospitalizations and a 34 percent reduction in total costs while improving quality. Click here to read results of the study.

About RCCA
Regional Cancer Care Associates (RCCA), one of the largest oncology physician networks in the United States, is transforming oncology care by ensuring that cancer patients have access to the highest-quality, most-comprehensive, cutting edge treatments in a compassionate and community-based setting. RCCA includes 100 cancer care specialists and is supported by 700 employees at 27 care delivery sites, providing care to more than 230,000 existing patients in New Jersey, Maryland and Washington DC.  For more information visit: http://www.RCCA.com

Contact:

Mary Lou Salvemini
msalvemini@regionalcancercare.org
(201) 510-0922

REGIONAL CANCER CARE ASSOCIATES AND AETNA FORM ONCOLOGY MEDICAL HOME

REGIONAL CANCER CARE ASSOCIATES AND AETNA FORM ONCOLOGY MEDICAL HOME

— The Patient-Focused Model Supports High-Value Care–

 

Hackensack, NJ, October 12, 2016 — Regional Cancer Care Associates (RCCA) and Aetna (NYSE: AET) announced a collaboration to create an oncology medical home that is designed to improve the care experience for cancer patients.

In the oncology medical home model, teams of cancer specialists collectively provide a patient’s health care when he or she has a cancer diagnosis. The model will give RCCA the responsibility to arrange appropriate care that is continuous and proactive and physicians will be incentivized for improved health, affordability and a better patient experience.

The oncology medical home arrangement will be available to patients at all RCCA locations in New Jersey and Maryland.

“RCCA is excited to partner with Aetna on this program. It aligns with our vision of providing patient centered care close to home,” said Terrill Jordan, RCCA President & CEO. “This partnership will not only enable us to continue the delivery of high quality care through reduced side effects, but will also facilitate cost effective care based on the data Aetna will be sharing,” said Michael Ruiz de Somocurcio, RCCA Vice President of Payer and Provider Collaboration.

The model is part of a strategic direction to transition from fee-for-service medicine to value-based payment. Value-based arrangements are emerging as a solution to address rising health care costs, clinical inefficiency, duplication of services, and access to care. In value-based models, doctors and hospitals are paid for helping to keep people healthy and for improving the health of those who have chronic conditions in an evidence-based, cost-effective way.

“We understand that cancer treatment can be the hardest experience that our members will ever have to go through,” said Daniel Knecht, M.D., M.B.A., Aetna’s Head of Strategy & Planning and Interim Head of Oncology Solutions. “This oncology medical home with RCCA will help provide our members with high-quality care and an optimal patient experience.”

The operating principles of the RCCA and Aetna oncology medical home include:

  • An orientation to the whole person. A personal physician from RCCA will be responsible for providing or arranging all of a patient’s health care needs with other qualified professionals. This includes care for all stages of treatment: preventive services, acute care, chronic care, palliative care and end-of-life care.
  • Evidence-based, personalized medical care. The RCCA team will focus on making treatment decisions based on current medical evidence for each unique disease presentation, patient-specific factors and patient choice using appropriate treatments to improve quality and outcomes.
  • Coordinated and integrated care. Care will be facilitated, across all elements of the health system, to enable Aetna members to get the appropriate care when and where it is needed and wanted, in a culturally and linguistically appropriate manner.
  • Quality and safety. Quality and safety will be a focus of care, including the use of evidence-based medicine, clinical decision support tools and accountability for continuous quality improvement.
  • Enhanced access to care. Care will be available through systems such as open scheduling, expanded hours and new options for communication between Aetna members, their personal physicians and hospital staff.

The oncology medical home arrangement launched in September 2016.

About RCCA

Regional Cancer Care Associates (RCCA), one of the largest oncology physician networks in the United States, is transforming oncology care by ensuring that cancer patients have access to the highest-quality, most-comprehensive, cutting edge treatments in a compassionate and community-based setting. RCCA includes 100 cancer care specialists and is supported by 700 employees at 27 care delivery sites, providing care to more than 23,000 new patients annually and over 230,000 existing patients in New Jersey, Maryland and Washington DC. For more information visit: http://www.RCCA.com.

About Aetna

Aetna is one of the nation’s leading diversified health care benefits companies, serving an estimated 46.3 million people with information and resources to help them make better informed decisions about their health care. Aetna offers a broad range of traditional, voluntary and consumer-directed health insurance products and related services, including medical, pharmacy, dental, behavioral health, group life and disability plans, and medical management capabilities, Medicaid health care management services, workers’ compensation administrative services and health information technology products and services. Aetna’s customers include employer groups, individuals, college students, part-time and hourly workers, health plans, health care providers, governmental units, government-sponsored plans, labor groups and expatriates. For more information, see www.aetna.com and learn about how Aetna is helping to build a healthier world. @AetnaNews

 

###

What Cancer Patients Need To Know About Clinical Trials: Insights From New Jersey Hematologist /Oncologist Seth Berk

Seth Howard Berk, MD, a hematologist and medical oncologist with RCCA, reveals four facts that he shares with his patients when they ask about clinical trials.

First, a drug has been thoroughly tested well before it reaches the clinical trial stage. Pre-clinical trial testing involves looking at a drug’s effects on animals as well as human cells. This stage usually takes years of development. Also, the clinical studies have to be designed and conducted in accordance with rigorous ethical and safety criteria.

He also imparts the importance of not thinking of clinical trials as a last resort in treatment. While trials are typically suited for situations in which traditional therapy methods are not working for a patient, there is more evidence emerging of late-stage trials benefitting the patient when used early in the diagnosis process.

A myth that Dr. Berk debunks is the use of a placebo in cancer treatment. Some cancer patients are resistant to clinical trials because they fear there will be a placebo and they will suffer as a result. He says this is misinformation or something assumed from a patient’s memory of high school or college science experiments. In clinical trials, one group will be administered the trial agent while the other continues to have traditional therapy. There are rarely ever patients receiving zero care.

Lastly, Dr. Berk addresses the importance of clinical trials for cancer patients in general. Because of willing patients participating in more and more trials, doctors and patients can share in a community of knowledge and understanding, and, one day, a cure.

To read more about clinical trials, turn to “What cancer patients need to know about clinical trials: Insights from New Jersey oncologist/hematologist Seth Berk.”

RCCA: Taking Cancer Care To A Higher Level In NJ And Beyond

Edward J. Licitra, MD, PhD, board certified in internal medicine, hematology and medical oncology and chairman of the board of directors of Regional Cancer Care Associates (RCCA), shares some of his thoughts on potential models for a health care delivery reform system. Oncologists at RCCA, totaling 100 physicians, learn from each other’s best practices with the patient’s interest at the forefront. Through RCCA, patients can receive care at home instead of visiting a hospital or clinic. They have set up 27 care delivery sites, providing care to more than 23,000 new patients annually and approximately 230,000 existing patients in New Jersey, Maryland and Washington, D.C.

Another example of a successful care reform case is the Oncology Care Model (OCM) created by Medicare under the Affordable Care Act (ACA). The model questions how to best develop an integrated style of cancer care. It focuses on developing a care model for the future, using data sharing and streamlining economics for patients as well as providers. By digitizing patients’ medical histories and sharing them through hospitals and clinics, this model focuses on simplifying the oncology care process.

Lastly, the OCM utilizes evidence-based-medicine (EBM) practices throughout the entire spectrum of care. EBM produces the best methods regardless of cost, while even reducing cost by eliminating wasteful spending. The OCM focuses on patient-focused, research based therapy tailored to the individual patient.

To learn more about this topic, read “RCCA: Taking cancer care to a higher level in NJ and beyond.”

Targeting Treatments for Chronic Lymphocytic Leukemia

Dr. Joel Silver

 

How do myeloma and chronic lymphocytic leukemia (CLL) develop? What are some risk factors associated with those malignancies?

A. We don’t know what causes CLL. We do know that people in some occupations or with a certain exposure history might be at higher risk, and that CLL generally affects older people. Treatment fortunately is not needed in many cases, but even so our treatment options have evolved based on cytogenetics and next-generation sequencing. We have more ways to assess prognostic features and design more personalized and potentially more effective therapy for people with CLL.

 

What therapies have been successful in treating CLL over the last two to three years?

A. If you can identify a certain kind of CLL, such as IDH-mutated CLL, some of the patients with it can receive a standard chemotherapy regimen called FCR, and they sometimes go into remission indefinitely. It depends on whether the patient is young and healthy enough to tolerate the therapy. That’s a select group, though; you don’t see too many young people with CLL.

Years ago, an effective treatment did not exist for another group of patients with CLL, those with the genetic 17p deletion. In recent years, however, the oral agent ibrutinib has shown effectiveness for CLL in this group. Other therapies now are available for patients who don’t respond to ibrutinib.

 

Where does targeted therapy come into play?

A. In general, “targeted therapy” refers to a treatment based on a particular mutation or pattern. The presence of the genetic 17p deletion in CLL is one example, but this is a bad cytogenetic abnormality for which standard treatments such as chemotherapy haven’t worked. If we can identify a particular mutation, then we can target our therapy and plan treatment that we know will work, instead of going through chemotherapies that are only partially effective or downright ineffective and then finding that the patient is resistant to treatment.

 

Are there side effects or drawbacks to targeted therapy?

A. Everything we do has side effects. The oral agent ibrutinib has been an effective first-line therapy for any type of CLL. Although the agent is specifically for patients with 17p deletion, it has also worked for patients without that genetic feature. While some cardiovascular and bleeding issues have been reported, ibrutinib overall is more tolerable than chemotherapy.

When we medically examine patients with CLL, we always look at a pattern of mutations to try to identify how to treat these people — not so much from an immediate therapeutic standpoint, but to gain knowledge of all these other cytogenetic abnormalities so that eventually, we will find other ways to target those different patterns.

What important points do you address with patients before they begin CLL therapy?

A. Many people with CLL don’t die of their disease, they die with their disease, so I tell patients not to be afraid of the disease itself. Many of the conversations we have with these people, however, revolve around the fact that they have this problem but may never need treatment. “We should follow you because you may need treatment down the line,” I tell them. “If you need treatment, we have many effective therapies.”

 

Do you foresee different therapies for CLL emerging within the next two to three years?

A. A number of medications are on the horizon that will be appropriate for any patient with CLL. For example, venetoclax, which gained FDA approval last year, is indicated for second-line treatment of CLL in patients with the 17p deletion, but I think that agent will be effective for all patients with CLL. As similarly versatile agents are developed, we will have many more treatment options.

Colorectal Cancer Trends in Maryland: A Conversation with Dr. Ralph V. Boccia

As the third most common cancer in the United States, colorectal cancer (CRC) affects about 1 in 20 Americans. However, incidence and death rates for cancer of the colorectum have significantly decreased over the past several decades as a result of increased screening and drastic improvements in treatment. In Maryland alone, approximately 70% of adults over the age of 50 have an up-to-date colorectal cancer screening, helping contribute to the reduction in mortality rates.

Dr. Ralph V. Boccia, an oncology and hematology specialist at Regional Cancer Care Associates (RCCA) in Bethesda and Germantown, Maryland says, “The more colorectal screening we have and the earlier it gets started, the lower the stage that the cancer is typically picked up.” In turn, early detection has led to the state’s lower mortality rates over time.

 

The Benefits Of Increased Screening

According to Dr. Boccia, improving screening rates “affects the stage at which the cancer presents itself and [the patient’s] potential for survival.” Between 2002 and 2010, the percentage of Maryland adults with up-to-date colorectal cancer screenings increased from 64% to 71%. As a result, CRC mortality rates in Maryland decreased considerably among both men and women in that eight-year timeframe. Dr. Boccia explains, “The trend we’ve actually seen – which is that more people are being screened – has resulted in more improvements of overall survival in patients with colorectal cancer.”

However, as colon cancer rates decline in adults 50 years and older, both incidence and death rates are increasing in the under-50 population. “We’re seeing a scary trend of younger patients getting colorectal cancer,” remarks Dr. Boccia, “even down into the 20s.” However, at this point in time, there’s insufficient data to clearly identify the causation behind this trend.

 

Colorectal Cancer Risk Factors

According to a report from the Maryland Department of Health and Mental Hygiene, the incidence rate of colon cancer per 100,000 people in Maryland was 1,174 for men and 1,109 for women in 2012. When looking at new cases of CRC, research shows that incidence may be tied to habits and lifestyles. Among these lifestyle- associated risk factors are being overweight or obese, lack of physical activity, smoking, heavy alcohol use and certain types of diets.

As outlined by the American Cancer Society, other risk factors unrelated to lifestyle choices are personal and family histories of colorectal cancer or adenomatous polyps, having type 2 diabetes, possessing an inherited syndrome, such as Lynch Syndrome, and certain racial and ethnic backgrounds. In addition, Dr. Boccia notes that a personal history of inflammatory bowel disease may increase the risk for developing colorectal cancer. “Patients with ulcerative colitis have to be screened very frequently for colon cancer,” Dr. Boccia elucidates, “because of that high predisposition.”

 

Common CRC Treatments

“For early stage colorectal cancer, the treatment of choice is surgery,” says Dr. Boccia. In this stage, a group of abnormal cells, referred to as carcinoma in situ (CIS), can be removed by a polypectomy, or a part of the colon can be removed via a partial colectomy. Once the cancer has penetrated the wall of the colon and perhaps even grown into nearby tissue, patients of RCCA Maryland will typically undergo active surveillance – although other treatment options are offered to those with high-risk tumors, says Dr. Boccia.

Once the cancer has reached Stage III, patients are generally offered a form of chemotherapy for roughly six weeks. “FOLFOX is the adjuvant therapy of choice,” says Dr. Boccia, “and that we know will lower the incidence of recurrence by about 40-50%.” For Stage IV diseases, which make up about 20% of the cases that RCCA Maryland sees each year, chemotherapy, targeted therapy and even immunotherapy can be used to offer aggressive treatment. If they no longer respond to a particular drug, patients will be introduced to a new regimen.

In regards to new research and treatment options, Dr. Boccia concludes, “I have 50 to 60 clinical trials open at all times in the center, so we’re always looking actively for good, cutting-edge therapies and offering those to our patients.”

 

If you or someone you love has been diagnosed with colorectal cancer, schedule an appointment at one of RCCA’s 29 locations in New Jersey, Maryland or Connecticut for personalized, professional care.

Molecular Testing: Tailoring Treatment by Targeting Pathways

Phillip D. Reid, MD

 

What is molecular testing? How it is used in cancer care?

A.  As we learn how to treat specific subtypes of cancer more accurately, molecular testing, molecular medicine and molecular diagnostics are becoming more prominent in oncology.

In the past, once a cancer was diagnosed, we determined the organ where it started, how much cancer was in the body and where it was. We have since discovered many pathways through which a cancer develops. We now need to know not only the stage, type and origin of cancer, but also the pathway through which it developed and then target that pathway.

 

How does the pathway concept affect therapy selection?

A.  It enhances our ability to treat the cancer, but we now need extra testing on a patient’s particular cancer cells. The great thing about molecular testing is we get an answer specific for the individual, not just for everyone, for example, with lung cancer. But it does require more time for us to find the pathway. From the patient’s standpoint, diagnosis and stage are obtained, and then sometimes we have to send off the cancer cells for extra testing, which increases the time between diagnosis and treatment. But ultimately, a better sense is provided of what drug to use and when to use it, and there’s a much greater likelihood of devising specific, effective treatment.

 

For which types of cancer should molecular testing be used?

A.  Molecular testing has revolutionized every major cancer diagnosis. Patients with lung and breast cancer are the best candidates, but molecular testing also is useful in colon cancer, head-and-neck and bladder cancer, and some leukemias and myelomas.

 

What have been the main developments over the last two to three years with molecular testing?

A.  It’s becoming easier and more standardized to get molecular testing done. A patient receives a diagnosis and his or her cancer is sent off to a lab, which evaluates all known pathways for that cancer. A specific result is received. As the patient receives therapy, sometimes the cancer changes and he or she may need a second or third biopsy one to three years after the initial diagnosis to see what’s changed in the cancer, and then the treatment changes based on that result. We now see cancer as a moving target as it progresses, and we have to recalibrate every few years so that we’re shooting that target correctly.

 

What should patients know about molecular testing before proceeding?

A.  After a patient receives his or her staging diagnosis, the next question is, “What subtype of lung cancer do I have and what pathway did the cancer use to develop?” The patient needs to have patience, as that extra information may not arrive for two to four weeks, but that information can increase the chances of treatment success.

Also ask about clinical trials of cancer medications before beginning therapy, because we often know about upcoming medications that are effective and possibly better than what we have right now.

Colorectal Cancer Trends and Treatment

Ralph V. Boccia, MD, a cancer specialist at RCCA Maryland, provides some insight into recent colorectal cancer trends and treatments that are giving new hope to doctors, researchers and patients nationwide. Overall, Dr. Boccia finds much to be encouraged by, but also points to the need for awareness of a concerning development in the field of colorectal cancer.

 

How Far We’ve Come and Where We’re Going

As a whole, colorectal cancer rates have been dropping. According to the National Cancer Institute and Centers for Disease Control and Prevention, Maryland alone has seen a 2.6% decrease in the amount of new CRC patients diagnosed over a five-year period. Dr. Boccia believes this trend can be partly attributed to the following:

  • Widespread increase in colonoscopies and other CRC screening methods
  • Early detection and removal of polyps before they become cancerous
  • More cases being diagnosed at an early stage – when the cancer is more responsive to treatment

Despite the good news, it’s still projected that 2,358 Maryland residents will be diagnosed and that 927 people will die from the disease this year, says Dr. Boccia. Doctors have also been noticing an uncharacteristic increase in the amount of younger adults being diagnosed with CRC. Since it typically affects individuals above the age of 50, this emerging demographic has been cause for concern. But Dr. Boccia and his colleagues will continue to conduct research and make further strides in colorectal cancer care to better serve patients of all ages.

 

Current Treatment Options

Surgical innovations, targeted therapies, immunotherapies, chemotherapy and clinical trials are paving the way for more effective CRC solutions. Dr. Boccia explains, “We have a greater ability than ever before to individualize care, and to offer patients multi-modal treatment regimens that employ a variety of mechanisms of action to combat cancer by different means.”

 

Reducing Your Risk

Follow these tips to help reduce your risk for developing colorectal cancer:

  • Maintain a healthy weight
  • Stay physically active
  • Avoid smoking cigarettes and only drink alcohol in moderation
  • Get a CRC screening regularly
  • Consult a physician right away if you experience any CRC symptoms, such as blood in the stool and persistent abdominal pain
  • Manage other conditions that may increase your risk for CRC, like type 2 diabetes, inflammatory bowel disease and adenomatous polyps

 

If you or someone you love has been diagnosed with colorectal cancer, schedule an appointment at one of RCCA’s 29 locations in New Jersey, Maryland or Connecticut for personalized, professional care.

RCCA Earns URAC Accreditation In Specialty Pharmacy

[Hackensack, NJ] – RCCA is proud to announce that it has earned URAC accreditation in Specialty Pharmacy. URAC is the independent leader in promoting healthcare quality through accreditation, certification and measurement. By achieving this status, RCCA has demonstrated a comprehensive commitment to quality care, improved processes and better patient outcomes.

 

“URAC Accreditation is a testament to the commitment of delivering the highest level of quality standards to our patients and their caregivers,” said Terrill Jordan, President and CEO of RCCA. ”This type of commitment is the cornerstone of everything we do at RCCA,” he added.

Edward Licitra, MD, PhD, RCCA Chairperson of the Board and RCCA Pharmacy Medical Director and Eileen Peng, PharmD, Director of the RCCA Pharmacy agree that “this new recognition will allow us to continue to provide the highest level of patient care and convenience for the people that need it the most.”

 

“Pharmacy services have never played such an important role in the delivery of care as they do today. RCCA distinguishes itself for having voluntarily undergone a rigorous review of quality standards that earned it URAC accreditation,” said URAC President and CEO Kylanne Green. “Independent URAC accreditation shows RCCA is dedicated to quality and safety, and that it strives for a continual improvement of its services.”

ABOUT RCCA

Regional Cancer Care Associates (RCCA), one of the largest oncology physician networks in the United States, is transforming oncology care by ensuring that cancer patients have access to the highest-quality, most-comprehensive, cutting edge treatments in a compassionate and community-based setting. RCCA includes more than 100 cancer care specialists and is supported by 800 employees at more than 30 care delivery sites, providing care to more than 24,000 new patients annually and over 240,000 existing patients.  For more information visit: http://www.RCCA.com

About URAC

Founded in 1990, URAC is the independent leader in promoting healthcare quality through accreditation, certification and measurement. URAC is a nonprofit organization developing evidence-based measures and standards through inclusive engagement with a range of stakeholders committed to improving the quality of healthcare. Our portfolio of accreditation and certification programs span the healthcare industry, addressing healthcare management, healthcare operations, health plans, pharmacies, telehealth providers, physician practices, and more. URAC accreditation is a symbol of excellence for organizations to showcase their validated commitment to quality and accountability.

For further information, contact:

Mary Lou Salvemini
msalvemini@regionalcancercare.org
(201) 510-0922

RCCA Makes Innovative UnitedHealthcare Cancer Care Program Available to Patients in Maryland

HACKENSACK, N.J., Nov. 22, 2016 /PRNewswire-USNewswire/ — Regional Cancer Care Associates (RCCA) is expanding its cancer care payment initiative with UnitedHealthcare to RCCA patients in Maryland who are covered by UnitedHealthcare benefit plans.

The program, made available at RCCA New Jersey locations in January, rewards physicians for focusing on best treatment practices, quality patient care and better health outcomes. The program pays participating medical oncologists more if they demonstrate superior clinical results and if they reduce the total cost of care.

The episode payment model shifts reimbursement away from the current “fee-for-service” approach that emphasizes volume of care delivered regardless of a patient’s health outcomes. The episode payment is based on the expected cost of a standard treatment regimen for a specific condition, as predetermined by the doctor. Similar payment models have been shown to enhance care coordination and improve health outcomes for patients, while reducing overall costs.

“RCCA has emerged as a leader in delivering the highest-level quality cancer care to our patients,” said Terrill Jordan, RCCA President and CEO. “New payment methodologies like this put patients’ interests at the forefront of cancer treatment. It also results in significant cost savings, which advances efforts across the country to assist in controlling rising health care costs. We are excited to offer this program to our Maryland patient base.”

Lee N. Newcomer, M.D., UnitedHealthcare’s Senior Vice President, Oncology, said: “Our partnership with RCCA marks an important step toward expanded episode payment models and away from the traditional fee-for-service payments for oncology care. We look forward to working with RCCA and others to expand our efforts to identify best practices for treating cancer.”

A study published in the Journal of Oncology Practice has demonstrated that this program reduced overall cancer expenses by more than a third while improving quality outcomes. RCCA is among five oncology practices that have joined the program, which now has a total of more than 650 oncologists. RCCA in New Jersey and now Maryland comprise approximately 100 of these oncologists.

“Value-based cancer care is here. This program will enable Maryland-based RCCA oncologists to continue to provide patient-centered care at the highest level of quality,” said Ralph Boccia, M.D., RCCA Research Deputy Chair and Oncologist in Bethesda and Germantown, Md.

UnitedHealthcare first implemented its episode payment program as a pilot study between October 2009 and December 2012. The pilot study produced a significant reduction in hospitalizations and a 34 percent reduction in total costs while improving quality. Click here to read results of the study.

About RCCA
Regional Cancer Care Associates (RCCA), one of the largest oncology physician networks in the United States, is transforming oncology care by ensuring that cancer patients have access to the highest-quality, most-comprehensive, cutting edge treatments in a compassionate and community-based setting. RCCA includes 100 cancer care specialists and is supported by 700 employees at 27 care delivery sites, providing care to more than 230,000 existing patients in New Jersey, Maryland and Washington DC.  For more information visit: http://www.RCCA.com

Contact:

Mary Lou Salvemini
msalvemini@regionalcancercare.org
(201) 510-0922

REGIONAL CANCER CARE ASSOCIATES AND AETNA FORM ONCOLOGY MEDICAL HOME

REGIONAL CANCER CARE ASSOCIATES AND AETNA FORM ONCOLOGY MEDICAL HOME

— The Patient-Focused Model Supports High-Value Care–

 

Hackensack, NJ, October 12, 2016 — Regional Cancer Care Associates (RCCA) and Aetna (NYSE: AET) announced a collaboration to create an oncology medical home that is designed to improve the care experience for cancer patients.

In the oncology medical home model, teams of cancer specialists collectively provide a patient’s health care when he or she has a cancer diagnosis. The model will give RCCA the responsibility to arrange appropriate care that is continuous and proactive and physicians will be incentivized for improved health, affordability and a better patient experience.

The oncology medical home arrangement will be available to patients at all RCCA locations in New Jersey and Maryland.

“RCCA is excited to partner with Aetna on this program. It aligns with our vision of providing patient centered care close to home,” said Terrill Jordan, RCCA President & CEO. “This partnership will not only enable us to continue the delivery of high quality care through reduced side effects, but will also facilitate cost effective care based on the data Aetna will be sharing,” said Michael Ruiz de Somocurcio, RCCA Vice President of Payer and Provider Collaboration.

The model is part of a strategic direction to transition from fee-for-service medicine to value-based payment. Value-based arrangements are emerging as a solution to address rising health care costs, clinical inefficiency, duplication of services, and access to care. In value-based models, doctors and hospitals are paid for helping to keep people healthy and for improving the health of those who have chronic conditions in an evidence-based, cost-effective way.

“We understand that cancer treatment can be the hardest experience that our members will ever have to go through,” said Daniel Knecht, M.D., M.B.A., Aetna’s Head of Strategy & Planning and Interim Head of Oncology Solutions. “This oncology medical home with RCCA will help provide our members with high-quality care and an optimal patient experience.”

The operating principles of the RCCA and Aetna oncology medical home include:

  • An orientation to the whole person. A personal physician from RCCA will be responsible for providing or arranging all of a patient’s health care needs with other qualified professionals. This includes care for all stages of treatment: preventive services, acute care, chronic care, palliative care and end-of-life care.
  • Evidence-based, personalized medical care. The RCCA team will focus on making treatment decisions based on current medical evidence for each unique disease presentation, patient-specific factors and patient choice using appropriate treatments to improve quality and outcomes.
  • Coordinated and integrated care. Care will be facilitated, across all elements of the health system, to enable Aetna members to get the appropriate care when and where it is needed and wanted, in a culturally and linguistically appropriate manner.
  • Quality and safety. Quality and safety will be a focus of care, including the use of evidence-based medicine, clinical decision support tools and accountability for continuous quality improvement.
  • Enhanced access to care. Care will be available through systems such as open scheduling, expanded hours and new options for communication between Aetna members, their personal physicians and hospital staff.

The oncology medical home arrangement launched in September 2016.

About RCCA

Regional Cancer Care Associates (RCCA), one of the largest oncology physician networks in the United States, is transforming oncology care by ensuring that cancer patients have access to the highest-quality, most-comprehensive, cutting edge treatments in a compassionate and community-based setting. RCCA includes 100 cancer care specialists and is supported by 700 employees at 27 care delivery sites, providing care to more than 23,000 new patients annually and over 230,000 existing patients in New Jersey, Maryland and Washington DC. For more information visit: http://www.RCCA.com.

About Aetna

Aetna is one of the nation’s leading diversified health care benefits companies, serving an estimated 46.3 million people with information and resources to help them make better informed decisions about their health care. Aetna offers a broad range of traditional, voluntary and consumer-directed health insurance products and related services, including medical, pharmacy, dental, behavioral health, group life and disability plans, and medical management capabilities, Medicaid health care management services, workers’ compensation administrative services and health information technology products and services. Aetna’s customers include employer groups, individuals, college students, part-time and hourly workers, health plans, health care providers, governmental units, government-sponsored plans, labor groups and expatriates. For more information, see www.aetna.com and learn about how Aetna is helping to build a healthier world. @AetnaNews

 

###

What Cancer Patients Need To Know About Clinical Trials: Insights From New Jersey Hematologist /Oncologist Seth Berk

Seth Howard Berk, MD, a hematologist and medical oncologist with RCCA, reveals four facts that he shares with his patients when they ask about clinical trials.

First, a drug has been thoroughly tested well before it reaches the clinical trial stage. Pre-clinical trial testing involves looking at a drug’s effects on animals as well as human cells. This stage usually takes years of development. Also, the clinical studies have to be designed and conducted in accordance with rigorous ethical and safety criteria.

He also imparts the importance of not thinking of clinical trials as a last resort in treatment. While trials are typically suited for situations in which traditional therapy methods are not working for a patient, there is more evidence emerging of late-stage trials benefitting the patient when used early in the diagnosis process.

A myth that Dr. Berk debunks is the use of a placebo in cancer treatment. Some cancer patients are resistant to clinical trials because they fear there will be a placebo and they will suffer as a result. He says this is misinformation or something assumed from a patient’s memory of high school or college science experiments. In clinical trials, one group will be administered the trial agent while the other continues to have traditional therapy. There are rarely ever patients receiving zero care.

Lastly, Dr. Berk addresses the importance of clinical trials for cancer patients in general. Because of willing patients participating in more and more trials, doctors and patients can share in a community of knowledge and understanding, and, one day, a cure.

To read more about clinical trials, turn to “What cancer patients need to know about clinical trials: Insights from New Jersey oncologist/hematologist Seth Berk.”

RCCA: Taking Cancer Care To A Higher Level In NJ And Beyond

Edward J. Licitra, MD, PhD, board certified in internal medicine, hematology and medical oncology and chairman of the board of directors of Regional Cancer Care Associates (RCCA), shares some of his thoughts on potential models for a health care delivery reform system. Oncologists at RCCA, totaling 100 physicians, learn from each other’s best practices with the patient’s interest at the forefront. Through RCCA, patients can receive care at home instead of visiting a hospital or clinic. They have set up 27 care delivery sites, providing care to more than 23,000 new patients annually and approximately 230,000 existing patients in New Jersey, Maryland and Washington, D.C.

Another example of a successful care reform case is the Oncology Care Model (OCM) created by Medicare under the Affordable Care Act (ACA). The model questions how to best develop an integrated style of cancer care. It focuses on developing a care model for the future, using data sharing and streamlining economics for patients as well as providers. By digitizing patients’ medical histories and sharing them through hospitals and clinics, this model focuses on simplifying the oncology care process.

Lastly, the OCM utilizes evidence-based-medicine (EBM) practices throughout the entire spectrum of care. EBM produces the best methods regardless of cost, while even reducing cost by eliminating wasteful spending. The OCM focuses on patient-focused, research based therapy tailored to the individual patient.

To learn more about this topic, read “RCCA: Taking cancer care to a higher level in NJ and beyond.”

Targeting Treatments for Chronic Lymphocytic Leukemia

Dr. Joel Silver

 

How do myeloma and chronic lymphocytic leukemia (CLL) develop? What are some risk factors associated with those malignancies?

A. We don’t know what causes CLL. We do know that people in some occupations or with a certain exposure history might be at higher risk, and that CLL generally affects older people. Treatment fortunately is not needed in many cases, but even so our treatment options have evolved based on cytogenetics and next-generation sequencing. We have more ways to assess prognostic features and design more personalized and potentially more effective therapy for people with CLL.

 

What therapies have been successful in treating CLL over the last two to three years?

A. If you can identify a certain kind of CLL, such as IDH-mutated CLL, some of the patients with it can receive a standard chemotherapy regimen called FCR, and they sometimes go into remission indefinitely. It depends on whether the patient is young and healthy enough to tolerate the therapy. That’s a select group, though; you don’t see too many young people with CLL.

Years ago, an effective treatment did not exist for another group of patients with CLL, those with the genetic 17p deletion. In recent years, however, the oral agent ibrutinib has shown effectiveness for CLL in this group. Other therapies now are available for patients who don’t respond to ibrutinib.

 

Where does targeted therapy come into play?

A. In general, “targeted therapy” refers to a treatment based on a particular mutation or pattern. The presence of the genetic 17p deletion in CLL is one example, but this is a bad cytogenetic abnormality for which standard treatments such as chemotherapy haven’t worked. If we can identify a particular mutation, then we can target our therapy and plan treatment that we know will work, instead of going through chemotherapies that are only partially effective or downright ineffective and then finding that the patient is resistant to treatment.

 

Are there side effects or drawbacks to targeted therapy?

A. Everything we do has side effects. The oral agent ibrutinib has been an effective first-line therapy for any type of CLL. Although the agent is specifically for patients with 17p deletion, it has also worked for patients without that genetic feature. While some cardiovascular and bleeding issues have been reported, ibrutinib overall is more tolerable than chemotherapy.

When we medically examine patients with CLL, we always look at a pattern of mutations to try to identify how to treat these people — not so much from an immediate therapeutic standpoint, but to gain knowledge of all these other cytogenetic abnormalities so that eventually, we will find other ways to target those different patterns.

What important points do you address with patients before they begin CLL therapy?

A. Many people with CLL don’t die of their disease, they die with their disease, so I tell patients not to be afraid of the disease itself. Many of the conversations we have with these people, however, revolve around the fact that they have this problem but may never need treatment. “We should follow you because you may need treatment down the line,” I tell them. “If you need treatment, we have many effective therapies.”

 

Do you foresee different therapies for CLL emerging within the next two to three years?

A. A number of medications are on the horizon that will be appropriate for any patient with CLL. For example, venetoclax, which gained FDA approval last year, is indicated for second-line treatment of CLL in patients with the 17p deletion, but I think that agent will be effective for all patients with CLL. As similarly versatile agents are developed, we will have many more treatment options.

Colorectal Cancer Trends in Maryland: A Conversation with Dr. Ralph V. Boccia

As the third most common cancer in the United States, colorectal cancer (CRC) affects about 1 in 20 Americans. However, incidence and death rates for cancer of the colorectum have significantly decreased over the past several decades as a result of increased screening and drastic improvements in treatment. In Maryland alone, approximately 70% of adults over the age of 50 have an up-to-date colorectal cancer screening, helping contribute to the reduction in mortality rates.

Dr. Ralph V. Boccia, an oncology and hematology specialist at Regional Cancer Care Associates (RCCA) in Bethesda and Germantown, Maryland says, “The more colorectal screening we have and the earlier it gets started, the lower the stage that the cancer is typically picked up.” In turn, early detection has led to the state’s lower mortality rates over time.

 

The Benefits Of Increased Screening

According to Dr. Boccia, improving screening rates “affects the stage at which the cancer presents itself and [the patient’s] potential for survival.” Between 2002 and 2010, the percentage of Maryland adults with up-to-date colorectal cancer screenings increased from 64% to 71%. As a result, CRC mortality rates in Maryland decreased considerably among both men and women in that eight-year timeframe. Dr. Boccia explains, “The trend we’ve actually seen – which is that more people are being screened – has resulted in more improvements of overall survival in patients with colorectal cancer.”

However, as colon cancer rates decline in adults 50 years and older, both incidence and death rates are increasing in the under-50 population. “We’re seeing a scary trend of younger patients getting colorectal cancer,” remarks Dr. Boccia, “even down into the 20s.” However, at this point in time, there’s insufficient data to clearly identify the causation behind this trend.

 

Colorectal Cancer Risk Factors

According to a report from the Maryland Department of Health and Mental Hygiene, the incidence rate of colon cancer per 100,000 people in Maryland was 1,174 for men and 1,109 for women in 2012. When looking at new cases of CRC, research shows that incidence may be tied to habits and lifestyles. Among these lifestyle- associated risk factors are being overweight or obese, lack of physical activity, smoking, heavy alcohol use and certain types of diets.

As outlined by the American Cancer Society, other risk factors unrelated to lifestyle choices are personal and family histories of colorectal cancer or adenomatous polyps, having type 2 diabetes, possessing an inherited syndrome, such as Lynch Syndrome, and certain racial and ethnic backgrounds. In addition, Dr. Boccia notes that a personal history of inflammatory bowel disease may increase the risk for developing colorectal cancer. “Patients with ulcerative colitis have to be screened very frequently for colon cancer,” Dr. Boccia elucidates, “because of that high predisposition.”

 

Common CRC Treatments

“For early stage colorectal cancer, the treatment of choice is surgery,” says Dr. Boccia. In this stage, a group of abnormal cells, referred to as carcinoma in situ (CIS), can be removed by a polypectomy, or a part of the colon can be removed via a partial colectomy. Once the cancer has penetrated the wall of the colon and perhaps even grown into nearby tissue, patients of RCCA Maryland will typically undergo active surveillance – although other treatment options are offered to those with high-risk tumors, says Dr. Boccia.

Once the cancer has reached Stage III, patients are generally offered a form of chemotherapy for roughly six weeks. “FOLFOX is the adjuvant therapy of choice,” says Dr. Boccia, “and that we know will lower the incidence of recurrence by about 40-50%.” For Stage IV diseases, which make up about 20% of the cases that RCCA Maryland sees each year, chemotherapy, targeted therapy and even immunotherapy can be used to offer aggressive treatment. If they no longer respond to a particular drug, patients will be introduced to a new regimen.

In regards to new research and treatment options, Dr. Boccia concludes, “I have 50 to 60 clinical trials open at all times in the center, so we’re always looking actively for good, cutting-edge therapies and offering those to our patients.”

 

If you or someone you love has been diagnosed with colorectal cancer, schedule an appointment at one of RCCA’s 29 locations in New Jersey, Maryland or Connecticut for personalized, professional care.

Molecular Testing: Tailoring Treatment by Targeting Pathways

Phillip D. Reid, MD

 

What is molecular testing? How it is used in cancer care?

A.  As we learn how to treat specific subtypes of cancer more accurately, molecular testing, molecular medicine and molecular diagnostics are becoming more prominent in oncology.

In the past, once a cancer was diagnosed, we determined the organ where it started, how much cancer was in the body and where it was. We have since discovered many pathways through which a cancer develops. We now need to know not only the stage, type and origin of cancer, but also the pathway through which it developed and then target that pathway.

 

How does the pathway concept affect therapy selection?

A.  It enhances our ability to treat the cancer, but we now need extra testing on a patient’s particular cancer cells. The great thing about molecular testing is we get an answer specific for the individual, not just for everyone, for example, with lung cancer. But it does require more time for us to find the pathway. From the patient’s standpoint, diagnosis and stage are obtained, and then sometimes we have to send off the cancer cells for extra testing, which increases the time between diagnosis and treatment. But ultimately, a better sense is provided of what drug to use and when to use it, and there’s a much greater likelihood of devising specific, effective treatment.

 

For which types of cancer should molecular testing be used?

A.  Molecular testing has revolutionized every major cancer diagnosis. Patients with lung and breast cancer are the best candidates, but molecular testing also is useful in colon cancer, head-and-neck and bladder cancer, and some leukemias and myelomas.

 

What have been the main developments over the last two to three years with molecular testing?

A.  It’s becoming easier and more standardized to get molecular testing done. A patient receives a diagnosis and his or her cancer is sent off to a lab, which evaluates all known pathways for that cancer. A specific result is received. As the patient receives therapy, sometimes the cancer changes and he or she may need a second or third biopsy one to three years after the initial diagnosis to see what’s changed in the cancer, and then the treatment changes based on that result. We now see cancer as a moving target as it progresses, and we have to recalibrate every few years so that we’re shooting that target correctly.

 

What should patients know about molecular testing before proceeding?

A.  After a patient receives his or her staging diagnosis, the next question is, “What subtype of lung cancer do I have and what pathway did the cancer use to develop?” The patient needs to have patience, as that extra information may not arrive for two to four weeks, but that information can increase the chances of treatment success.

Also ask about clinical trials of cancer medications before beginning therapy, because we often know about upcoming medications that are effective and possibly better than what we have right now.

Colorectal Cancer Trends and Treatment

Ralph V. Boccia, MD, a cancer specialist at RCCA Maryland, provides some insight into recent colorectal cancer trends and treatments that are giving new hope to doctors, researchers and patients nationwide. Overall, Dr. Boccia finds much to be encouraged by, but also points to the need for awareness of a concerning development in the field of colorectal cancer.

 

How Far We’ve Come and Where We’re Going

As a whole, colorectal cancer rates have been dropping. According to the National Cancer Institute and Centers for Disease Control and Prevention, Maryland alone has seen a 2.6% decrease in the amount of new CRC patients diagnosed over a five-year period. Dr. Boccia believes this trend can be partly attributed to the following:

  • Widespread increase in colonoscopies and other CRC screening methods
  • Early detection and removal of polyps before they become cancerous
  • More cases being diagnosed at an early stage – when the cancer is more responsive to treatment

Despite the good news, it’s still projected that 2,358 Maryland residents will be diagnosed and that 927 people will die from the disease this year, says Dr. Boccia. Doctors have also been noticing an uncharacteristic increase in the amount of younger adults being diagnosed with CRC. Since it typically affects individuals above the age of 50, this emerging demographic has been cause for concern. But Dr. Boccia and his colleagues will continue to conduct research and make further strides in colorectal cancer care to better serve patients of all ages.

 

Current Treatment Options

Surgical innovations, targeted therapies, immunotherapies, chemotherapy and clinical trials are paving the way for more effective CRC solutions. Dr. Boccia explains, “We have a greater ability than ever before to individualize care, and to offer patients multi-modal treatment regimens that employ a variety of mechanisms of action to combat cancer by different means.”

 

Reducing Your Risk

Follow these tips to help reduce your risk for developing colorectal cancer:

  • Maintain a healthy weight
  • Stay physically active
  • Avoid smoking cigarettes and only drink alcohol in moderation
  • Get a CRC screening regularly
  • Consult a physician right away if you experience any CRC symptoms, such as blood in the stool and persistent abdominal pain
  • Manage other conditions that may increase your risk for CRC, like type 2 diabetes, inflammatory bowel disease and adenomatous polyps

 

If you or someone you love has been diagnosed with colorectal cancer, schedule an appointment at one of RCCA’s 29 locations in New Jersey, Maryland or Connecticut for personalized, professional care.

RCCA Earns URAC Accreditation In Specialty Pharmacy

[Hackensack, NJ] – RCCA is proud to announce that it has earned URAC accreditation in Specialty Pharmacy. URAC is the independent leader in promoting healthcare quality through accreditation, certification and measurement. By achieving this status, RCCA has demonstrated a comprehensive commitment to quality care, improved processes and better patient outcomes.

 

“URAC Accreditation is a testament to the commitment of delivering the highest level of quality standards to our patients and their caregivers,” said Terrill Jordan, President and CEO of RCCA. ”This type of commitment is the cornerstone of everything we do at RCCA,” he added.

Edward Licitra, MD, PhD, RCCA Chairperson of the Board and RCCA Pharmacy Medical Director and Eileen Peng, PharmD, Director of the RCCA Pharmacy agree that “this new recognition will allow us to continue to provide the highest level of patient care and convenience for the people that need it the most.”

 

“Pharmacy services have never played such an important role in the delivery of care as they do today. RCCA distinguishes itself for having voluntarily undergone a rigorous review of quality standards that earned it URAC accreditation,” said URAC President and CEO Kylanne Green. “Independent URAC accreditation shows RCCA is dedicated to quality and safety, and that it strives for a continual improvement of its services.”

ABOUT RCCA

Regional Cancer Care Associates (RCCA), one of the largest oncology physician networks in the United States, is transforming oncology care by ensuring that cancer patients have access to the highest-quality, most-comprehensive, cutting edge treatments in a compassionate and community-based setting. RCCA includes more than 100 cancer care specialists and is supported by 800 employees at more than 30 care delivery sites, providing care to more than 24,000 new patients annually and over 240,000 existing patients.  For more information visit: http://www.RCCA.com

About URAC

Founded in 1990, URAC is the independent leader in promoting healthcare quality through accreditation, certification and measurement. URAC is a nonprofit organization developing evidence-based measures and standards through inclusive engagement with a range of stakeholders committed to improving the quality of healthcare. Our portfolio of accreditation and certification programs span the healthcare industry, addressing healthcare management, healthcare operations, health plans, pharmacies, telehealth providers, physician practices, and more. URAC accreditation is a symbol of excellence for organizations to showcase their validated commitment to quality and accountability.

For further information, contact:

Mary Lou Salvemini
msalvemini@regionalcancercare.org
(201) 510-0922

RCCA Makes Innovative UnitedHealthcare Cancer Care Program Available to Patients in Maryland

HACKENSACK, N.J., Nov. 22, 2016 /PRNewswire-USNewswire/ — Regional Cancer Care Associates (RCCA) is expanding its cancer care payment initiative with UnitedHealthcare to RCCA patients in Maryland who are covered by UnitedHealthcare benefit plans.

The program, made available at RCCA New Jersey locations in January, rewards physicians for focusing on best treatment practices, quality patient care and better health outcomes. The program pays participating medical oncologists more if they demonstrate superior clinical results and if they reduce the total cost of care.

The episode payment model shifts reimbursement away from the current “fee-for-service” approach that emphasizes volume of care delivered regardless of a patient’s health outcomes. The episode payment is based on the expected cost of a standard treatment regimen for a specific condition, as predetermined by the doctor. Similar payment models have been shown to enhance care coordination and improve health outcomes for patients, while reducing overall costs.

“RCCA has emerged as a leader in delivering the highest-level quality cancer care to our patients,” said Terrill Jordan, RCCA President and CEO. “New payment methodologies like this put patients’ interests at the forefront of cancer treatment. It also results in significant cost savings, which advances efforts across the country to assist in controlling rising health care costs. We are excited to offer this program to our Maryland patient base.”

Lee N. Newcomer, M.D., UnitedHealthcare’s Senior Vice President, Oncology, said: “Our partnership with RCCA marks an important step toward expanded episode payment models and away from the traditional fee-for-service payments for oncology care. We look forward to working with RCCA and others to expand our efforts to identify best practices for treating cancer.”

A study published in the Journal of Oncology Practice has demonstrated that this program reduced overall cancer expenses by more than a third while improving quality outcomes. RCCA is among five oncology practices that have joined the program, which now has a total of more than 650 oncologists. RCCA in New Jersey and now Maryland comprise approximately 100 of these oncologists.

“Value-based cancer care is here. This program will enable Maryland-based RCCA oncologists to continue to provide patient-centered care at the highest level of quality,” said Ralph Boccia, M.D., RCCA Research Deputy Chair and Oncologist in Bethesda and Germantown, Md.

UnitedHealthcare first implemented its episode payment program as a pilot study between October 2009 and December 2012. The pilot study produced a significant reduction in hospitalizations and a 34 percent reduction in total costs while improving quality. Click here to read results of the study.

About RCCA
Regional Cancer Care Associates (RCCA), one of the largest oncology physician networks in the United States, is transforming oncology care by ensuring that cancer patients have access to the highest-quality, most-comprehensive, cutting edge treatments in a compassionate and community-based setting. RCCA includes 100 cancer care specialists and is supported by 700 employees at 27 care delivery sites, providing care to more than 230,000 existing patients in New Jersey, Maryland and Washington DC.  For more information visit: http://www.RCCA.com

Contact:

Mary Lou Salvemini
msalvemini@regionalcancercare.org
(201) 510-0922

REGIONAL CANCER CARE ASSOCIATES AND AETNA FORM ONCOLOGY MEDICAL HOME

REGIONAL CANCER CARE ASSOCIATES AND AETNA FORM ONCOLOGY MEDICAL HOME

— The Patient-Focused Model Supports High-Value Care–

 

Hackensack, NJ, October 12, 2016 — Regional Cancer Care Associates (RCCA) and Aetna (NYSE: AET) announced a collaboration to create an oncology medical home that is designed to improve the care experience for cancer patients.

In the oncology medical home model, teams of cancer specialists collectively provide a patient’s health care when he or she has a cancer diagnosis. The model will give RCCA the responsibility to arrange appropriate care that is continuous and proactive and physicians will be incentivized for improved health, affordability and a better patient experience.

The oncology medical home arrangement will be available to patients at all RCCA locations in New Jersey and Maryland.

“RCCA is excited to partner with Aetna on this program. It aligns with our vision of providing patient centered care close to home,” said Terrill Jordan, RCCA President & CEO. “This partnership will not only enable us to continue the delivery of high quality care through reduced side effects, but will also facilitate cost effective care based on the data Aetna will be sharing,” said Michael Ruiz de Somocurcio, RCCA Vice President of Payer and Provider Collaboration.

The model is part of a strategic direction to transition from fee-for-service medicine to value-based payment. Value-based arrangements are emerging as a solution to address rising health care costs, clinical inefficiency, duplication of services, and access to care. In value-based models, doctors and hospitals are paid for helping to keep people healthy and for improving the health of those who have chronic conditions in an evidence-based, cost-effective way.

“We understand that cancer treatment can be the hardest experience that our members will ever have to go through,” said Daniel Knecht, M.D., M.B.A., Aetna’s Head of Strategy & Planning and Interim Head of Oncology Solutions. “This oncology medical home with RCCA will help provide our members with high-quality care and an optimal patient experience.”

The operating principles of the RCCA and Aetna oncology medical home include:

  • An orientation to the whole person. A personal physician from RCCA will be responsible for providing or arranging all of a patient’s health care needs with other qualified professionals. This includes care for all stages of treatment: preventive services, acute care, chronic care, palliative care and end-of-life care.
  • Evidence-based, personalized medical care. The RCCA team will focus on making treatment decisions based on current medical evidence for each unique disease presentation, patient-specific factors and patient choice using appropriate treatments to improve quality and outcomes.
  • Coordinated and integrated care. Care will be facilitated, across all elements of the health system, to enable Aetna members to get the appropriate care when and where it is needed and wanted, in a culturally and linguistically appropriate manner.
  • Quality and safety. Quality and safety will be a focus of care, including the use of evidence-based medicine, clinical decision support tools and accountability for continuous quality improvement.
  • Enhanced access to care. Care will be available through systems such as open scheduling, expanded hours and new options for communication between Aetna members, their personal physicians and hospital staff.

The oncology medical home arrangement launched in September 2016.

About RCCA

Regional Cancer Care Associates (RCCA), one of the largest oncology physician networks in the United States, is transforming oncology care by ensuring that cancer patients have access to the highest-quality, most-comprehensive, cutting edge treatments in a compassionate and community-based setting. RCCA includes 100 cancer care specialists and is supported by 700 employees at 27 care delivery sites, providing care to more than 23,000 new patients annually and over 230,000 existing patients in New Jersey, Maryland and Washington DC. For more information visit: http://www.RCCA.com.

About Aetna

Aetna is one of the nation’s leading diversified health care benefits companies, serving an estimated 46.3 million people with information and resources to help them make better informed decisions about their health care. Aetna offers a broad range of traditional, voluntary and consumer-directed health insurance products and related services, including medical, pharmacy, dental, behavioral health, group life and disability plans, and medical management capabilities, Medicaid health care management services, workers’ compensation administrative services and health information technology products and services. Aetna’s customers include employer groups, individuals, college students, part-time and hourly workers, health plans, health care providers, governmental units, government-sponsored plans, labor groups and expatriates. For more information, see www.aetna.com and learn about how Aetna is helping to build a healthier world. @AetnaNews

 

###

What Cancer Patients Need To Know About Clinical Trials: Insights From New Jersey Hematologist /Oncologist Seth Berk

Seth Howard Berk, MD, a hematologist and medical oncologist with RCCA, reveals four facts that he shares with his patients when they ask about clinical trials.

First, a drug has been thoroughly tested well before it reaches the clinical trial stage. Pre-clinical trial testing involves looking at a drug’s effects on animals as well as human cells. This stage usually takes years of development. Also, the clinical studies have to be designed and conducted in accordance with rigorous ethical and safety criteria.

He also imparts the importance of not thinking of clinical trials as a last resort in treatment. While trials are typically suited for situations in which traditional therapy methods are not working for a patient, there is more evidence emerging of late-stage trials benefitting the patient when used early in the diagnosis process.

A myth that Dr. Berk debunks is the use of a placebo in cancer treatment. Some cancer patients are resistant to clinical trials because they fear there will be a placebo and they will suffer as a result. He says this is misinformation or something assumed from a patient’s memory of high school or college science experiments. In clinical trials, one group will be administered the trial agent while the other continues to have traditional therapy. There are rarely ever patients receiving zero care.

Lastly, Dr. Berk addresses the importance of clinical trials for cancer patients in general. Because of willing patients participating in more and more trials, doctors and patients can share in a community of knowledge and understanding, and, one day, a cure.

To read more about clinical trials, turn to “What cancer patients need to know about clinical trials: Insights from New Jersey oncologist/hematologist Seth Berk.”

RCCA: Taking Cancer Care To A Higher Level In NJ And Beyond

Edward J. Licitra, MD, PhD, board certified in internal medicine, hematology and medical oncology and chairman of the board of directors of Regional Cancer Care Associates (RCCA), shares some of his thoughts on potential models for a health care delivery reform system. Oncologists at RCCA, totaling 100 physicians, learn from each other’s best practices with the patient’s interest at the forefront. Through RCCA, patients can receive care at home instead of visiting a hospital or clinic. They have set up 27 care delivery sites, providing care to more than 23,000 new patients annually and approximately 230,000 existing patients in New Jersey, Maryland and Washington, D.C.

Another example of a successful care reform case is the Oncology Care Model (OCM) created by Medicare under the Affordable Care Act (ACA). The model questions how to best develop an integrated style of cancer care. It focuses on developing a care model for the future, using data sharing and streamlining economics for patients as well as providers. By digitizing patients’ medical histories and sharing them through hospitals and clinics, this model focuses on simplifying the oncology care process.

Lastly, the OCM utilizes evidence-based-medicine (EBM) practices throughout the entire spectrum of care. EBM produces the best methods regardless of cost, while even reducing cost by eliminating wasteful spending. The OCM focuses on patient-focused, research based therapy tailored to the individual patient.

To learn more about this topic, read “RCCA: Taking cancer care to a higher level in NJ and beyond.”

Targeting Treatments for Chronic Lymphocytic Leukemia

Dr. Joel Silver

 

How do myeloma and chronic lymphocytic leukemia (CLL) develop? What are some risk factors associated with those malignancies?

A. We don’t know what causes CLL. We do know that people in some occupations or with a certain exposure history might be at higher risk, and that CLL generally affects older people. Treatment fortunately is not needed in many cases, but even so our treatment options have evolved based on cytogenetics and next-generation sequencing. We have more ways to assess prognostic features and design more personalized and potentially more effective therapy for people with CLL.

 

What therapies have been successful in treating CLL over the last two to three years?

A. If you can identify a certain kind of CLL, such as IDH-mutated CLL, some of the patients with it can receive a standard chemotherapy regimen called FCR, and they sometimes go into remission indefinitely. It depends on whether the patient is young and healthy enough to tolerate the therapy. That’s a select group, though; you don’t see too many young people with CLL.

Years ago, an effective treatment did not exist for another group of patients with CLL, those with the genetic 17p deletion. In recent years, however, the oral agent ibrutinib has shown effectiveness for CLL in this group. Other therapies now are available for patients who don’t respond to ibrutinib.

 

Where does targeted therapy come into play?

A. In general, “targeted therapy” refers to a treatment based on a particular mutation or pattern. The presence of the genetic 17p deletion in CLL is one example, but this is a bad cytogenetic abnormality for which standard treatments such as chemotherapy haven’t worked. If we can identify a particular mutation, then we can target our therapy and plan treatment that we know will work, instead of going through chemotherapies that are only partially effective or downright ineffective and then finding that the patient is resistant to treatment.

 

Are there side effects or drawbacks to targeted therapy?

A. Everything we do has side effects. The oral agent ibrutinib has been an effective first-line therapy for any type of CLL. Although the agent is specifically for patients with 17p deletion, it has also worked for patients without that genetic feature. While some cardiovascular and bleeding issues have been reported, ibrutinib overall is more tolerable than chemotherapy.

When we medically examine patients with CLL, we always look at a pattern of mutations to try to identify how to treat these people — not so much from an immediate therapeutic standpoint, but to gain knowledge of all these other cytogenetic abnormalities so that eventually, we will find other ways to target those different patterns.

What important points do you address with patients before they begin CLL therapy?

A. Many people with CLL don’t die of their disease, they die with their disease, so I tell patients not to be afraid of the disease itself. Many of the conversations we have with these people, however, revolve around the fact that they have this problem but may never need treatment. “We should follow you because you may need treatment down the line,” I tell them. “If you need treatment, we have many effective therapies.”

 

Do you foresee different therapies for CLL emerging within the next two to three years?

A. A number of medications are on the horizon that will be appropriate for any patient with CLL. For example, venetoclax, which gained FDA approval last year, is indicated for second-line treatment of CLL in patients with the 17p deletion, but I think that agent will be effective for all patients with CLL. As similarly versatile agents are developed, we will have many more treatment options.

Colorectal Cancer Trends in Maryland: A Conversation with Dr. Ralph V. Boccia

As the third most common cancer in the United States, colorectal cancer (CRC) affects about 1 in 20 Americans. However, incidence and death rates for cancer of the colorectum have significantly decreased over the past several decades as a result of increased screening and drastic improvements in treatment. In Maryland alone, approximately 70% of adults over the age of 50 have an up-to-date colorectal cancer screening, helping contribute to the reduction in mortality rates.

Dr. Ralph V. Boccia, an oncology and hematology specialist at Regional Cancer Care Associates (RCCA) in Bethesda and Germantown, Maryland says, “The more colorectal screening we have and the earlier it gets started, the lower the stage that the cancer is typically picked up.” In turn, early detection has led to the state’s lower mortality rates over time.

 

The Benefits Of Increased Screening

According to Dr. Boccia, improving screening rates “affects the stage at which the cancer presents itself and [the patient’s] potential for survival.” Between 2002 and 2010, the percentage of Maryland adults with up-to-date colorectal cancer screenings increased from 64% to 71%. As a result, CRC mortality rates in Maryland decreased considerably among both men and women in that eight-year timeframe. Dr. Boccia explains, “The trend we’ve actually seen – which is that more people are being screened – has resulted in more improvements of overall survival in patients with colorectal cancer.”

However, as colon cancer rates decline in adults 50 years and older, both incidence and death rates are increasing in the under-50 population. “We’re seeing a scary trend of younger patients getting colorectal cancer,” remarks Dr. Boccia, “even down into the 20s.” However, at this point in time, there’s insufficient data to clearly identify the causation behind this trend.

 

Colorectal Cancer Risk Factors

According to a report from the Maryland Department of Health and Mental Hygiene, the incidence rate of colon cancer per 100,000 people in Maryland was 1,174 for men and 1,109 for women in 2012. When looking at new cases of CRC, research shows that incidence may be tied to habits and lifestyles. Among these lifestyle- associated risk factors are being overweight or obese, lack of physical activity, smoking, heavy alcohol use and certain types of diets.

As outlined by the American Cancer Society, other risk factors unrelated to lifestyle choices are personal and family histories of colorectal cancer or adenomatous polyps, having type 2 diabetes, possessing an inherited syndrome, such as Lynch Syndrome, and certain racial and ethnic backgrounds. In addition, Dr. Boccia notes that a personal history of inflammatory bowel disease may increase the risk for developing colorectal cancer. “Patients with ulcerative colitis have to be screened very frequently for colon cancer,” Dr. Boccia elucidates, “because of that high predisposition.”

 

Common CRC Treatments

“For early stage colorectal cancer, the treatment of choice is surgery,” says Dr. Boccia. In this stage, a group of abnormal cells, referred to as carcinoma in situ (CIS), can be removed by a polypectomy, or a part of the colon can be removed via a partial colectomy. Once the cancer has penetrated the wall of the colon and perhaps even grown into nearby tissue, patients of RCCA Maryland will typically undergo active surveillance – although other treatment options are offered to those with high-risk tumors, says Dr. Boccia.

Once the cancer has reached Stage III, patients are generally offered a form of chemotherapy for roughly six weeks. “FOLFOX is the adjuvant therapy of choice,” says Dr. Boccia, “and that we know will lower the incidence of recurrence by about 40-50%.” For Stage IV diseases, which make up about 20% of the cases that RCCA Maryland sees each year, chemotherapy, targeted therapy and even immunotherapy can be used to offer aggressive treatment. If they no longer respond to a particular drug, patients will be introduced to a new regimen.

In regards to new research and treatment options, Dr. Boccia concludes, “I have 50 to 60 clinical trials open at all times in the center, so we’re always looking actively for good, cutting-edge therapies and offering those to our patients.”

 

If you or someone you love has been diagnosed with colorectal cancer, schedule an appointment at one of RCCA’s 29 locations in New Jersey, Maryland or Connecticut for personalized, professional care.

Molecular Testing: Tailoring Treatment by Targeting Pathways

Phillip D. Reid, MD

 

What is molecular testing? How it is used in cancer care?

A.  As we learn how to treat specific subtypes of cancer more accurately, molecular testing, molecular medicine and molecular diagnostics are becoming more prominent in oncology.

In the past, once a cancer was diagnosed, we determined the organ where it started, how much cancer was in the body and where it was. We have since discovered many pathways through which a cancer develops. We now need to know not only the stage, type and origin of cancer, but also the pathway through which it developed and then target that pathway.

 

How does the pathway concept affect therapy selection?

A.  It enhances our ability to treat the cancer, but we now need extra testing on a patient’s particular cancer cells. The great thing about molecular testing is we get an answer specific for the individual, not just for everyone, for example, with lung cancer. But it does require more time for us to find the pathway. From the patient’s standpoint, diagnosis and stage are obtained, and then sometimes we have to send off the cancer cells for extra testing, which increases the time between diagnosis and treatment. But ultimately, a better sense is provided of what drug to use and when to use it, and there’s a much greater likelihood of devising specific, effective treatment.

 

For which types of cancer should molecular testing be used?

A.  Molecular testing has revolutionized every major cancer diagnosis. Patients with lung and breast cancer are the best candidates, but molecular testing also is useful in colon cancer, head-and-neck and bladder cancer, and some leukemias and myelomas.

 

What have been the main developments over the last two to three years with molecular testing?

A.  It’s becoming easier and more standardized to get molecular testing done. A patient receives a diagnosis and his or her cancer is sent off to a lab, which evaluates all known pathways for that cancer. A specific result is received. As the patient receives therapy, sometimes the cancer changes and he or she may need a second or third biopsy one to three years after the initial diagnosis to see what’s changed in the cancer, and then the treatment changes based on that result. We now see cancer as a moving target as it progresses, and we have to recalibrate every few years so that we’re shooting that target correctly.

 

What should patients know about molecular testing before proceeding?

A.  After a patient receives his or her staging diagnosis, the next question is, “What subtype of lung cancer do I have and what pathway did the cancer use to develop?” The patient needs to have patience, as that extra information may not arrive for two to four weeks, but that information can increase the chances of treatment success.

Also ask about clinical trials of cancer medications before beginning therapy, because we often know about upcoming medications that are effective and possibly better than what we have right now.

Colorectal Cancer Trends and Treatment

Ralph V. Boccia, MD, a cancer specialist at RCCA Maryland, provides some insight into recent colorectal cancer trends and treatments that are giving new hope to doctors, researchers and patients nationwide. Overall, Dr. Boccia finds much to be encouraged by, but also points to the need for awareness of a concerning development in the field of colorectal cancer.

 

How Far We’ve Come and Where We’re Going

As a whole, colorectal cancer rates have been dropping. According to the National Cancer Institute and Centers for Disease Control and Prevention, Maryland alone has seen a 2.6% decrease in the amount of new CRC patients diagnosed over a five-year period. Dr. Boccia believes this trend can be partly attributed to the following:

  • Widespread increase in colonoscopies and other CRC screening methods
  • Early detection and removal of polyps before they become cancerous
  • More cases being diagnosed at an early stage – when the cancer is more responsive to treatment

Despite the good news, it’s still projected that 2,358 Maryland residents will be diagnosed and that 927 people will die from the disease this year, says Dr. Boccia. Doctors have also been noticing an uncharacteristic increase in the amount of younger adults being diagnosed with CRC. Since it typically affects individuals above the age of 50, this emerging demographic has been cause for concern. But Dr. Boccia and his colleagues will continue to conduct research and make further strides in colorectal cancer care to better serve patients of all ages.

 

Current Treatment Options

Surgical innovations, targeted therapies, immunotherapies, chemotherapy and clinical trials are paving the way for more effective CRC solutions. Dr. Boccia explains, “We have a greater ability than ever before to individualize care, and to offer patients multi-modal treatment regimens that employ a variety of mechanisms of action to combat cancer by different means.”

 

Reducing Your Risk

Follow these tips to help reduce your risk for developing colorectal cancer:

  • Maintain a healthy weight
  • Stay physically active
  • Avoid smoking cigarettes and only drink alcohol in moderation
  • Get a CRC screening regularly
  • Consult a physician right away if you experience any CRC symptoms, such as blood in the stool and persistent abdominal pain
  • Manage other conditions that may increase your risk for CRC, like type 2 diabetes, inflammatory bowel disease and adenomatous polyps

 

If you or someone you love has been diagnosed with colorectal cancer, schedule an appointment at one of RCCA’s 29 locations in New Jersey, Maryland or Connecticut for personalized, professional care.

RCCA Earns URAC Accreditation In Specialty Pharmacy

[Hackensack, NJ] – RCCA is proud to announce that it has earned URAC accreditation in Specialty Pharmacy. URAC is the independent leader in promoting healthcare quality through accreditation, certification and measurement. By achieving this status, RCCA has demonstrated a comprehensive commitment to quality care, improved processes and better patient outcomes.

 

“URAC Accreditation is a testament to the commitment of delivering the highest level of quality standards to our patients and their caregivers,” said Terrill Jordan, President and CEO of RCCA. ”This type of commitment is the cornerstone of everything we do at RCCA,” he added.

Edward Licitra, MD, PhD, RCCA Chairperson of the Board and RCCA Pharmacy Medical Director and Eileen Peng, PharmD, Director of the RCCA Pharmacy agree that “this new recognition will allow us to continue to provide the highest level of patient care and convenience for the people that need it the most.”

 

“Pharmacy services have never played such an important role in the delivery of care as they do today. RCCA distinguishes itself for having voluntarily undergone a rigorous review of quality standards that earned it URAC accreditation,” said URAC President and CEO Kylanne Green. “Independent URAC accreditation shows RCCA is dedicated to quality and safety, and that it strives for a continual improvement of its services.”

ABOUT RCCA

Regional Cancer Care Associates (RCCA), one of the largest oncology physician networks in the United States, is transforming oncology care by ensuring that cancer patients have access to the highest-quality, most-comprehensive, cutting edge treatments in a compassionate and community-based setting. RCCA includes more than 100 cancer care specialists and is supported by 800 employees at more than 30 care delivery sites, providing care to more than 24,000 new patients annually and over 240,000 existing patients.  For more information visit: http://www.RCCA.com

About URAC

Founded in 1990, URAC is the independent leader in promoting healthcare quality through accreditation, certification and measurement. URAC is a nonprofit organization developing evidence-based measures and standards through inclusive engagement with a range of stakeholders committed to improving the quality of healthcare. Our portfolio of accreditation and certification programs span the healthcare industry, addressing healthcare management, healthcare operations, health plans, pharmacies, telehealth providers, physician practices, and more. URAC accreditation is a symbol of excellence for organizations to showcase their validated commitment to quality and accountability.

For further information, contact:

Mary Lou Salvemini
msalvemini@regionalcancercare.org
(201) 510-0922

RCCA Makes Innovative UnitedHealthcare Cancer Care Program Available to Patients in Maryland

HACKENSACK, N.J., Nov. 22, 2016 /PRNewswire-USNewswire/ — Regional Cancer Care Associates (RCCA) is expanding its cancer care payment initiative with UnitedHealthcare to RCCA patients in Maryland who are covered by UnitedHealthcare benefit plans.

The program, made available at RCCA New Jersey locations in January, rewards physicians for focusing on best treatment practices, quality patient care and better health outcomes. The program pays participating medical oncologists more if they demonstrate superior clinical results and if they reduce the total cost of care.

The episode payment model shifts reimbursement away from the current “fee-for-service” approach that emphasizes volume of care delivered regardless of a patient’s health outcomes. The episode payment is based on the expected cost of a standard treatment regimen for a specific condition, as predetermined by the doctor. Similar payment models have been shown to enhance care coordination and improve health outcomes for patients, while reducing overall costs.

“RCCA has emerged as a leader in delivering the highest-level quality cancer care to our patients,” said Terrill Jordan, RCCA President and CEO. “New payment methodologies like this put patients’ interests at the forefront of cancer treatment. It also results in significant cost savings, which advances efforts across the country to assist in controlling rising health care costs. We are excited to offer this program to our Maryland patient base.”

Lee N. Newcomer, M.D., UnitedHealthcare’s Senior Vice President, Oncology, said: “Our partnership with RCCA marks an important step toward expanded episode payment models and away from the traditional fee-for-service payments for oncology care. We look forward to working with RCCA and others to expand our efforts to identify best practices for treating cancer.”

A study published in the Journal of Oncology Practice has demonstrated that this program reduced overall cancer expenses by more than a third while improving quality outcomes. RCCA is among five oncology practices that have joined the program, which now has a total of more than 650 oncologists. RCCA in New Jersey and now Maryland comprise approximately 100 of these oncologists.

“Value-based cancer care is here. This program will enable Maryland-based RCCA oncologists to continue to provide patient-centered care at the highest level of quality,” said Ralph Boccia, M.D., RCCA Research Deputy Chair and Oncologist in Bethesda and Germantown, Md.

UnitedHealthcare first implemented its episode payment program as a pilot study between October 2009 and December 2012. The pilot study produced a significant reduction in hospitalizations and a 34 percent reduction in total costs while improving quality. Click here to read results of the study.

About RCCA
Regional Cancer Care Associates (RCCA), one of the largest oncology physician networks in the United States, is transforming oncology care by ensuring that cancer patients have access to the highest-quality, most-comprehensive, cutting edge treatments in a compassionate and community-based setting. RCCA includes 100 cancer care specialists and is supported by 700 employees at 27 care delivery sites, providing care to more than 230,000 existing patients in New Jersey, Maryland and Washington DC.  For more information visit: http://www.RCCA.com

Contact:

Mary Lou Salvemini
msalvemini@regionalcancercare.org
(201) 510-0922

REGIONAL CANCER CARE ASSOCIATES AND AETNA FORM ONCOLOGY MEDICAL HOME

REGIONAL CANCER CARE ASSOCIATES AND AETNA FORM ONCOLOGY MEDICAL HOME

— The Patient-Focused Model Supports High-Value Care–

 

Hackensack, NJ, October 12, 2016 — Regional Cancer Care Associates (RCCA) and Aetna (NYSE: AET) announced a collaboration to create an oncology medical home that is designed to improve the care experience for cancer patients.

In the oncology medical home model, teams of cancer specialists collectively provide a patient’s health care when he or she has a cancer diagnosis. The model will give RCCA the responsibility to arrange appropriate care that is continuous and proactive and physicians will be incentivized for improved health, affordability and a better patient experience.

The oncology medical home arrangement will be available to patients at all RCCA locations in New Jersey and Maryland.

“RCCA is excited to partner with Aetna on this program. It aligns with our vision of providing patient centered care close to home,” said Terrill Jordan, RCCA President & CEO. “This partnership will not only enable us to continue the delivery of high quality care through reduced side effects, but will also facilitate cost effective care based on the data Aetna will be sharing,” said Michael Ruiz de Somocurcio, RCCA Vice President of Payer and Provider Collaboration.

The model is part of a strategic direction to transition from fee-for-service medicine to value-based payment. Value-based arrangements are emerging as a solution to address rising health care costs, clinical inefficiency, duplication of services, and access to care. In value-based models, doctors and hospitals are paid for helping to keep people healthy and for improving the health of those who have chronic conditions in an evidence-based, cost-effective way.

“We understand that cancer treatment can be the hardest experience that our members will ever have to go through,” said Daniel Knecht, M.D., M.B.A., Aetna’s Head of Strategy & Planning and Interim Head of Oncology Solutions. “This oncology medical home with RCCA will help provide our members with high-quality care and an optimal patient experience.”

The operating principles of the RCCA and Aetna oncology medical home include:

  • An orientation to the whole person. A personal physician from RCCA will be responsible for providing or arranging all of a patient’s health care needs with other qualified professionals. This includes care for all stages of treatment: preventive services, acute care, chronic care, palliative care and end-of-life care.
  • Evidence-based, personalized medical care. The RCCA team will focus on making treatment decisions based on current medical evidence for each unique disease presentation, patient-specific factors and patient choice using appropriate treatments to improve quality and outcomes.
  • Coordinated and integrated care. Care will be facilitated, across all elements of the health system, to enable Aetna members to get the appropriate care when and where it is needed and wanted, in a culturally and linguistically appropriate manner.
  • Quality and safety. Quality and safety will be a focus of care, including the use of evidence-based medicine, clinical decision support tools and accountability for continuous quality improvement.
  • Enhanced access to care. Care will be available through systems such as open scheduling, expanded hours and new options for communication between Aetna members, their personal physicians and hospital staff.

The oncology medical home arrangement launched in September 2016.

About RCCA

Regional Cancer Care Associates (RCCA), one of the largest oncology physician networks in the United States, is transforming oncology care by ensuring that cancer patients have access to the highest-quality, most-comprehensive, cutting edge treatments in a compassionate and community-based setting. RCCA includes 100 cancer care specialists and is supported by 700 employees at 27 care delivery sites, providing care to more than 23,000 new patients annually and over 230,000 existing patients in New Jersey, Maryland and Washington DC. For more information visit: http://www.RCCA.com.

About Aetna

Aetna is one of the nation’s leading diversified health care benefits companies, serving an estimated 46.3 million people with information and resources to help them make better informed decisions about their health care. Aetna offers a broad range of traditional, voluntary and consumer-directed health insurance products and related services, including medical, pharmacy, dental, behavioral health, group life and disability plans, and medical management capabilities, Medicaid health care management services, workers’ compensation administrative services and health information technology products and services. Aetna’s customers include employer groups, individuals, college students, part-time and hourly workers, health plans, health care providers, governmental units, government-sponsored plans, labor groups and expatriates. For more information, see www.aetna.com and learn about how Aetna is helping to build a healthier world. @AetnaNews

 

###

What Cancer Patients Need To Know About Clinical Trials: Insights From New Jersey Hematologist /Oncologist Seth Berk

Seth Howard Berk, MD, a hematologist and medical oncologist with RCCA, reveals four facts that he shares with his patients when they ask about clinical trials.

First, a drug has been thoroughly tested well before it reaches the clinical trial stage. Pre-clinical trial testing involves looking at a drug’s effects on animals as well as human cells. This stage usually takes years of development. Also, the clinical studies have to be designed and conducted in accordance with rigorous ethical and safety criteria.

He also imparts the importance of not thinking of clinical trials as a last resort in treatment. While trials are typically suited for situations in which traditional therapy methods are not working for a patient, there is more evidence emerging of late-stage trials benefitting the patient when used early in the diagnosis process.

A myth that Dr. Berk debunks is the use of a placebo in cancer treatment. Some cancer patients are resistant to clinical trials because they fear there will be a placebo and they will suffer as a result. He says this is misinformation or something assumed from a patient’s memory of high school or college science experiments. In clinical trials, one group will be administered the trial agent while the other continues to have traditional therapy. There are rarely ever patients receiving zero care.

Lastly, Dr. Berk addresses the importance of clinical trials for cancer patients in general. Because of willing patients participating in more and more trials, doctors and patients can share in a community of knowledge and understanding, and, one day, a cure.

To read more about clinical trials, turn to “What cancer patients need to know about clinical trials: Insights from New Jersey oncologist/hematologist Seth Berk.”

RCCA: Taking Cancer Care To A Higher Level In NJ And Beyond

Edward J. Licitra, MD, PhD, board certified in internal medicine, hematology and medical oncology and chairman of the board of directors of Regional Cancer Care Associates (RCCA), shares some of his thoughts on potential models for a health care delivery reform system. Oncologists at RCCA, totaling 100 physicians, learn from each other’s best practices with the patient’s interest at the forefront. Through RCCA, patients can receive care at home instead of visiting a hospital or clinic. They have set up 27 care delivery sites, providing care to more than 23,000 new patients annually and approximately 230,000 existing patients in New Jersey, Maryland and Washington, D.C.

Another example of a successful care reform case is the Oncology Care Model (OCM) created by Medicare under the Affordable Care Act (ACA). The model questions how to best develop an integrated style of cancer care. It focuses on developing a care model for the future, using data sharing and streamlining economics for patients as well as providers. By digitizing patients’ medical histories and sharing them through hospitals and clinics, this model focuses on simplifying the oncology care process.

Lastly, the OCM utilizes evidence-based-medicine (EBM) practices throughout the entire spectrum of care. EBM produces the best methods regardless of cost, while even reducing cost by eliminating wasteful spending. The OCM focuses on patient-focused, research based therapy tailored to the individual patient.

To learn more about this topic, read “RCCA: Taking cancer care to a higher level in NJ and beyond.”

Targeting Treatments for Chronic Lymphocytic Leukemia

Dr. Joel Silver

 

How do myeloma and chronic lymphocytic leukemia (CLL) develop? What are some risk factors associated with those malignancies?

A. We don’t know what causes CLL. We do know that people in some occupations or with a certain exposure history might be at higher risk, and that CLL generally affects older people. Treatment fortunately is not needed in many cases, but even so our treatment options have evolved based on cytogenetics and next-generation sequencing. We have more ways to assess prognostic features and design more personalized and potentially more effective therapy for people with CLL.

 

What therapies have been successful in treating CLL over the last two to three years?

A. If you can identify a certain kind of CLL, such as IDH-mutated CLL, some of the patients with it can receive a standard chemotherapy regimen called FCR, and they sometimes go into remission indefinitely. It depends on whether the patient is young and healthy enough to tolerate the therapy. That’s a select group, though; you don’t see too many young people with CLL.

Years ago, an effective treatment did not exist for another group of patients with CLL, those with the genetic 17p deletion. In recent years, however, the oral agent ibrutinib has shown effectiveness for CLL in this group. Other therapies now are available for patients who don’t respond to ibrutinib.

 

Where does targeted therapy come into play?

A. In general, “targeted therapy” refers to a treatment based on a particular mutation or pattern. The presence of the genetic 17p deletion in CLL is one example, but this is a bad cytogenetic abnormality for which standard treatments such as chemotherapy haven’t worked. If we can identify a particular mutation, then we can target our therapy and plan treatment that we know will work, instead of going through chemotherapies that are only partially effective or downright ineffective and then finding that the patient is resistant to treatment.

 

Are there side effects or drawbacks to targeted therapy?

A. Everything we do has side effects. The oral agent ibrutinib has been an effective first-line therapy for any type of CLL. Although the agent is specifically for patients with 17p deletion, it has also worked for patients without that genetic feature. While some cardiovascular and bleeding issues have been reported, ibrutinib overall is more tolerable than chemotherapy.

When we medically examine patients with CLL, we always look at a pattern of mutations to try to identify how to treat these people — not so much from an immediate therapeutic standpoint, but to gain knowledge of all these other cytogenetic abnormalities so that eventually, we will find other ways to target those different patterns.

What important points do you address with patients before they begin CLL therapy?

A. Many people with CLL don’t die of their disease, they die with their disease, so I tell patients not to be afraid of the disease itself. Many of the conversations we have with these people, however, revolve around the fact that they have this problem but may never need treatment. “We should follow you because you may need treatment down the line,” I tell them. “If you need treatment, we have many effective therapies.”

 

Do you foresee different therapies for CLL emerging within the next two to three years?

A. A number of medications are on the horizon that will be appropriate for any patient with CLL. For example, venetoclax, which gained FDA approval last year, is indicated for second-line treatment of CLL in patients with the 17p deletion, but I think that agent will be effective for all patients with CLL. As similarly versatile agents are developed, we will have many more treatment options.

Colorectal Cancer Trends in Maryland: A Conversation with Dr. Ralph V. Boccia

As the third most common cancer in the United States, colorectal cancer (CRC) affects about 1 in 20 Americans. However, incidence and death rates for cancer of the colorectum have significantly decreased over the past several decades as a result of increased screening and drastic improvements in treatment. In Maryland alone, approximately 70% of adults over the age of 50 have an up-to-date colorectal cancer screening, helping contribute to the reduction in mortality rates.

Dr. Ralph V. Boccia, an oncology and hematology specialist at Regional Cancer Care Associates (RCCA) in Bethesda and Germantown, Maryland says, “The more colorectal screening we have and the earlier it gets started, the lower the stage that the cancer is typically picked up.” In turn, early detection has led to the state’s lower mortality rates over time.

 

The Benefits Of Increased Screening

According to Dr. Boccia, improving screening rates “affects the stage at which the cancer presents itself and [the patient’s] potential for survival.” Between 2002 and 2010, the percentage of Maryland adults with up-to-date colorectal cancer screenings increased from 64% to 71%. As a result, CRC mortality rates in Maryland decreased considerably among both men and women in that eight-year timeframe. Dr. Boccia explains, “The trend we’ve actually seen – which is that more people are being screened – has resulted in more improvements of overall survival in patients with colorectal cancer.”

However, as colon cancer rates decline in adults 50 years and older, both incidence and death rates are increasing in the under-50 population. “We’re seeing a scary trend of younger patients getting colorectal cancer,” remarks Dr. Boccia, “even down into the 20s.” However, at this point in time, there’s insufficient data to clearly identify the causation behind this trend.

 

Colorectal Cancer Risk Factors

According to a report from the Maryland Department of Health and Mental Hygiene, the incidence rate of colon cancer per 100,000 people in Maryland was 1,174 for men and 1,109 for women in 2012. When looking at new cases of CRC, research shows that incidence may be tied to habits and lifestyles. Among these lifestyle- associated risk factors are being overweight or obese, lack of physical activity, smoking, heavy alcohol use and certain types of diets.

As outlined by the American Cancer Society, other risk factors unrelated to lifestyle choices are personal and family histories of colorectal cancer or adenomatous polyps, having type 2 diabetes, possessing an inherited syndrome, such as Lynch Syndrome, and certain racial and ethnic backgrounds. In addition, Dr. Boccia notes that a personal history of inflammatory bowel disease may increase the risk for developing colorectal cancer. “Patients with ulcerative colitis have to be screened very frequently for colon cancer,” Dr. Boccia elucidates, “because of that high predisposition.”

 

Common CRC Treatments

“For early stage colorectal cancer, the treatment of choice is surgery,” says Dr. Boccia. In this stage, a group of abnormal cells, referred to as carcinoma in situ (CIS), can be removed by a polypectomy, or a part of the colon can be removed via a partial colectomy. Once the cancer has penetrated the wall of the colon and perhaps even grown into nearby tissue, patients of RCCA Maryland will typically undergo active surveillance – although other treatment options are offered to those with high-risk tumors, says Dr. Boccia.

Once the cancer has reached Stage III, patients are generally offered a form of chemotherapy for roughly six weeks. “FOLFOX is the adjuvant therapy of choice,” says Dr. Boccia, “and that we know will lower the incidence of recurrence by about 40-50%.” For Stage IV diseases, which make up about 20% of the cases that RCCA Maryland sees each year, chemotherapy, targeted therapy and even immunotherapy can be used to offer aggressive treatment. If they no longer respond to a particular drug, patients will be introduced to a new regimen.

In regards to new research and treatment options, Dr. Boccia concludes, “I have 50 to 60 clinical trials open at all times in the center, so we’re always looking actively for good, cutting-edge therapies and offering those to our patients.”

 

If you or someone you love has been diagnosed with colorectal cancer, schedule an appointment at one of RCCA’s 29 locations in New Jersey, Maryland or Connecticut for personalized, professional care.

Molecular Testing: Tailoring Treatment by Targeting Pathways

Phillip D. Reid, MD

 

What is molecular testing? How it is used in cancer care?

A.  As we learn how to treat specific subtypes of cancer more accurately, molecular testing, molecular medicine and molecular d