In 2011, community-based cancer specialists were celebrating rapidly improving developments for their patients. But at the same time, the outlook for their practices was less than bright.
This dichotomy was due to several reasons: Costly mandates associated with health care reform, a consolidation of practices on terms dictated by large organizations that undercut community-based oncologists’ autonomy and ability to provide patients effective treatments, and a shift away from fee-for-service medicine.
That’s when hematologists and medical oncologists from 10 different New Jersey practices created Regional Cancer Care Associates, LLC, (RCCA) on Jan. 1, 2012. After a decade, RCCA has become one of the nation’s largest networks of oncology specialists. It has been so successful that it now has locations in Connecticut, Maryland and Washington, DC.
RCCA now has more than 20 care centers with 80 specialists who see more than 20,000 new patients each year, and who care for an additional 200,000-plus established patients.
RCCA care centers treat patients with blood-based cancers, solid tumors and benign blood disorders including anemia. The centers also provide infusion services to individuals who take intravenous medications for a variety of non-oncologic conditions, such as multiple sclerosis, Crohn’s disease, asthma and rheumatoid arthritis.
A ‘Best Of Both Worlds’ Approach
“The success of RCCA in many ways is attributable to our providing patients and clinicians alike with what might be termed the ‘best of both worlds,’” said Denis Fitzgerald, MD, a board-certified hematologist and medical oncologist who practices in RCCA’s Little Silver offices and serves as RCCA board chairperson.
“Many years ago, people with cancer faced a difficult trade-off. Receiving care in their own community was far more convenient than traveling to a major academic medical center in New York City, Philadelphia, or elsewhere, but local oncology practices sometimes couldn’t provide patients with access to the latest therapies, diagnostics or clinical trials,” Dr. Fitzgerald said. “In establishing RCCA, we were determined to preserve and enhance the best aspects of community-based care — such as the personalized experience we offer and the close connections we have with our patients’ other physicians — while accelerating the trend to make cutting-edge therapies available in the community setting, where more than 80% of cancer care is delivered. As a result of that commitment, our RCCA care centers today are able to offer patients the latest treatments, including targeted therapy and immunotherapies, while also enabling patients to enroll in clinical trials of investigational approaches.”
The RCCA oncology network employs a similarly balanced approach to providing its cancer specialists with the benefits of both affiliation and autonomy, said Terrill Jordan, LLM, JD, the president and chief executive officer of RCCA.
“With RCCA, medical oncologists and hematologists enjoy the advantages of scale in operating their practices and responding to the trends reshaping health care delivery, while maintaining the autonomy that comes from being part of an organization whose board is composed overwhelmingly of their fellow physicians.”
Rapid Growth — And Other Markers Of Performance
RCCA’s success can be measured by several metrics, beginning with growth. In a little less than 10 years, it has become one of the nation’s largest oncology-specialist networks.
“RCCA offers cancer specialists the business expertise and lean infrastructure needed to help them navigate new reimbursement methodologies, draw on real-world evidence databases, and enjoy economies of scale so that they can focus on patient care while practicing within a physician-directed organization,” Jordan said. “In talking with the oncologists who have joined RCCA in recent years, and those preparing to join us in the months ahead, those organizational capabilities have been a major motivator.”
Matching operational expertise with clinical excellence is one reason RCCA was one of almost 200 practices nationwide invited to implement the Centers for Medicare and Medicaid Services’ (CMS) Oncology Care Model (OCM). The OCM program works to enhance care for patients receiving chemotherapy, and bases reimbursement on various quality indicators.
“The approach taken by the OCM initiative is entirely aligned with our commitment to providing value-based care, and we are honored to help develop an approach that is becoming the norm throughout oncology and all of medicine,” Jordan said.
Additionally, RCCA consistently receives some of the nation’s highest patient-satisfaction rankings in annual surveys conducted by the Community Oncology Alliance, a non-profit advocacy organization.
An Ongoing Priority: Collaboration With Patients’ Other Physicians
One thing that RCCA has always excelled at — effective communication and collaboration with a patient’s other physicians — has taken on a greater importance this year, and promises to be a priority in the years ahead, said Iuliana Shapira, MD, RCCA’s chief medical officer.
“As community-based cancer specialists, we always have been able to offer our patients the advantages of our practicing in the same towns and often the same hospitals as their primary care providers, cardiologists, Ob/Gyns, urologists and other physicians,” Dr. Shapira said. “The rapport we enjoy with those colleagues has facilitated ready consultations and a multidisciplinary approach to our shared patients’ overall care.”
Now, she adds, as RCCA builds out the “oncology medical home” approach that it initiated a few years ago, the organization and its cancer specialists will take collaboration to the next level.
“The concept of a ‘medical home’ originated in primary care, and reflected the need to identify and attend to the full range of a person’s medical needs rather than putting the burden on the patient to navigate our fragmented health care system on his or her own,” Dr. Shapira said. “As the range of services we can provide to people with cancer has expanded, RCCA has adapted this model to oncology, so that we can manage patients’ needs for everything from genetic testing and counseling to diagnostic imaging, and from multi-modal treatment regimens to palliative care. While we’re doing all of that within oncology, we’re also working to ensure that we’re attuned to patients’ needs beyond oncology, and are collaborating effectively with our colleagues who are responsible for managing comorbidities so that we’re optimizing patients’ overall health and quality of life.”
Clinical leaders at RCCA say this collaboration means extending communication to specialists who refer patients to RCCA care centers for intravenous medications for a wide array of non-oncology conditions.
Looking Ahead — Meeting Emerging Challenges While Enhancing Patient Outcomes
As RCCA looks ahead to its second decade, the group finds itself able to treat a wide range of patients with diagnostics and therapies that are driving up survival rates for numerous cancers, Dr. Fitzgerald said.
“This is an incredibly exciting time to be practicing hematology and oncology,” Dr. Fitzgerald said. “Diagnoses that a decade ago would have prompted referral to palliative care or hospice today can be managed as chronic conditions with which patients can expect to live for many years — and with a good quality of life. In other cases, we are pursuing outright cure for cases where that was not a realistic goal even a few years earlier. Advances in prevention, diagnosis, genomics, and therapeutics promise to accelerate this progress at a rapid pace.”
He said that one of the greatest challenges RCCA will face will be to ensure that all people are able to benefit from these advances in cancer care. That, he said, is the mission of RCCA.
“As we mark and move beyond our 10th anniversary, we look forward to working with our colleagues in doing the work that drew all of us to medicine in the first place — enhancing the health and lives of our patients,” he said.
RCCA: 7 facts for physicians
- 80 cancer specialists at more than 20 care centers in New Jersey, Connecticut, Maryland and the Washington, DC area.
- Community-based immunotherapy, targeted therapy, chemotherapy and other treatment modalities, as well as diagnostics, and full array of cancer care services.
- Participation in hundreds of office-based clinical trials.
- Close communication, collaboration with other physicians in managing the overall care of their mutual patients.
- Consistently earns some of the highest patient-satisfaction ratings in the nation in annual surveys conducted by the Community Oncology Alliance.
- RCCA’s medical oncologists/hematologists also manage a wide range of benign blood disorders, including anemia and coagulopathies.
- RCCA care centers provide expert infusion services for patients whose neurologists, allergists, rheumatologists, pulmonologists, gastroenterologists and other physicians have prescribed intravenous medications for conditions including multiple sclerosis, asthma, and Crohn’s disease, among many others.
For more information about how RCCA works with referring doctors and other medical specialists involved in patients’ care, call (844) 474-6866.