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Stacey W. MucCullough, David Blaisdell, Jonathan K. Kish, Pat Farmer, JaLyna Laney, Tom Valuck, Natalie Dickson, Johnetta Blakely, Dianna Shipley, Jesus Berdeja, Gregg Shepard, Bertrand M. Anz III, Carolyn Kelsey, Jack Taylor, Chadi Nabhan, Jeffrey F. Patton, and Annette Powers

many community practices integrate specialty pharmacy (SP) services into their practice, patient education, treatment adherence, and visit scheduling coordination are becoming increasingly complex, particularly for treatments with Risk Evaluation and

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David P. Ryan

The relationship between the academic cancer center and the community cancer center is undergoing a dramatic cultural change. Community hospitals across the Northeast are building fully functional cancer centers where they provide all the services

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Neelima Denduluri, Debra A. Patt, Yunfei Wang, Menaka Bhor, Xiaoyan Li, Anne M. Favret, Phuong Khanh Morrow, Richard L. Barron, Lina Asmar, Shanmugapriya Saravanan, Yanli Li, Jacob Garcia, and Gary H. Lyman

relative to standard chemotherapy regimens among 16,233 patients with 6 tumor types who were treated with adjuvant or neoadjuvant chemotherapy regimens currently in widespread use in community oncology practices in the United States. Methods Data

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Margaret Tempero

I think it started in 2004. I happened to be President of ASCO at the time and we had a crisis: the Medicare Modernization Act. Cuts in reimbursement for drugs threatened the financial stability of community oncologists around the country. It was

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Diana I. Brixner, Gary M. Oderda, Nancy A. Nickman, Roy Beveridge, and James A. Jorgenson

Significant changes in Medicare reimbursement for outpatient oncology services were proposed as part of the Medicare Modernization Act of 2003. The purpose of this study was to identify the “true cost” associated with drug-related handling for the preparation and delivery of chemotherapy doses to estimate the impact of changing reimbursement schema by Medicare. Two academic medical outpatient infusion centers and 2 community cancer centers provided data used to estimate all costs (excluding drug cost) associated with the preparation of chemotherapy doses. The data included both fixed costs (drug storage, space, equipment, and information resources) and variable costs (insurance management, inventory, waste management, pharmacy staff payroll, supplies, and shipping). The average cost for the preparation of chemotherapy doses across all sites was $34.27 (range, $32.08–$41.23). A time-and-motion study was also performed to determine what tasks were conducted by pharmacy staff and how much time was spent in the preparation of the top 15 chemotherapeutic drugs and regimens used in the 4 sites. Data from the 4 centers was projected to show that if 3,990,495 million chemotherapy infusions were administered to a national Medicare population in 2003, when multiplied by the average cost of preparation for infusions determined by the current study ($34.27), the estimated total annual cost to Medicare for chemotherapy preparation by pharmacists is $136,754,263.65. The pharmacists spent most of their days (90% or more) performing tasks directly related to the preparation of these agents. These data provide scientific support for the consideration of appropriate reimbursement for chemotherapy services provided by pharmacists to Medicare beneficiaries.

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Brad Zebrack, Karen Kayser, Deborah Bybee, Lynne Padgett, Laura Sundstrom, Chad Jobin, and Julianne Oktay

, Comprehensive Community Cancer Program, Community Cancer Program (CCP), or NCI-designated Comprehensive Cancer Center Program (NCIP), which is based on type of facility, services provided, and number of analytic cases per year. 14 Cancer program registries were

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Adrian Legaspi, Vanitha Vasudevan, Amit Sastry, Jeronimo Garcialopez de Llano, and Marice Ruiz-Conejo

malignancy managed with RACS in a community hospital. Methods: comparative study of the first 57patients treated with RACS for malignant tumors done from 6/17 to 7/19 in a community hospital. The data was then compared to the published literature. Two

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Gabriela Abigail Villanueva

marginalized groups. Our objective is to provide quality palliative care to oncology Hispanic patients along the Mexico-US border by using community health workers (promotoras) to deliver a comprehensive and culturally sensitive educational intervention. We

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Margaret A. O'Grady, Elena Gitelson, Ramona F. Swaby, Lori J. Goldstein, Elaine Sein, Patricia Keeley, Bonnie Miller, Tianyu Li, Alan Weinstein, and Steven J. Cohen

Fox Chase Cancer Center Partners (FCCCP) is a community hospital/academic partnership consisting of 25 hospitals in the Delaware Valley. Originally created in 1986, FCCCP promotes quality community cancer care through education, quality assurance, and access to clinical trial research. An important aspect of quality assurance is a yearly medical oncology audit that benchmarks quality indicators and guidelines and provides a roadmap for quality improvement initiatives in the community oncology clinical office setting. Each year, the FCCCP team and the Partner Medical Oncologists build disease site- and stage-specific indicators based on National Comprehensive Cancer Network (NCCN) Clinical Practice Guidelines in Oncology. Concordance with multiple indicators is assessed on 20 charts from each community practice. A report for each FCCCP medical oncology practice summarizes documentation, screening recommendations, new drug use, and research trends in a particular disease site. Descriptive statistics reflect indicators met, number of new cases seen per year, number of disease site cases from tumor registry information, and clinical trial accrual total. Education and documentation tools are provided to physicians and oncology office nursing staff. The FCCCP Clinical Operations Team, consisting of medical oncologists and oncology-certified nurses, has conducted quality audits in medical oncology offices for 7 years using NCCN-derived indicators. Successful audits comprising gastric, colorectal, and breast cancer have been the focus of recent evaluations. For the 2005 stage II/III breast cancer evaluation, mean compliance per parameter was 88%, with 15 of 16 practices achieving mean compliance greater than 80%. A large-scale quality assurance audit in a community cancer partner network is feasible. Recent evaluation of localized breast cancer shows high compliance with guidelines and identifies areas for focused education. Partnership between academic and community oncologists produces a quality review process that is broadly applicable and adaptable to changing medical knowledge.

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Bianca Lewis, Caitlin R. Meeker, Elizabeth Handorf, Kelly Filchner, Rino Seedor, Jennifer S. Winn, Lori J. Goldstein, and Efrat Dotan

analysis, we sought to describe the psychosocial profile of older community patients with MBC, and investigate the correlation between psychosocial factors and presence of other GA abnormalities. Methods: This study included hands-on experience