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Michael A. Kolodziej

Medical oncology is an incredibly interesting and rewarding field of medicine. In no other area has change been so dramatic over such a short time. Furthermore, in no other area have the fruits of basic scientific labor been applied in such a tangible way to improve the care of patients. As a community oncologist, it has been my pleasure to be on the frontlines, as a witness to and participant in this reformation. However, we do have our challenges. Community oncologists are being assaulted on several fronts, frequently in the context of the uncontrolled costs of cancer care. Community oncologists are often cast in the role of villain, as part of the problem rather than part of the solution. In my role as a Medical Director for US Oncology, I have been involved in discussions and debates surrounding many of these contentious issues, from reimbursement reform to Centers for Medicare & Medicaid (CMS) and FDA policy to comparative effectiveness research. I have been frustrated by my perception that community oncologists are being marginalized in these discussions, despite the expectation that these same community providers will enthusiastically support, contribute to, and ultimately implement these programs. At a recent meeting about what comparative effectiveness will actually look like, I asked in exasperation, “As a provider, what do you want me to do?” I offer here a modest proposal for what we can and should do. Commitment to Evidence-Based Medicine The rapid rise in the costs associated with health care is certainly mind-boggling....
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Christian G. Downs, Liz Fowler, Michael Kolodziej, Lee H. Newcomer, Mohammed S. Ogaily, W. Thomas Purcell, John C. Winkelmann and Clifford Goodman

The Affordable Care Act (ACA) is a transformational event for health care in the United States, with multiple impacts on health care, the economy, and society. Oncologists and other health care providers are already experiencing many changes—direct and indirect, anticipated and unanticipated. A distinguished and diverse panel assembled at the NCCN 19th Annual Conference to discuss the early phase of implementation of the ACA. The roundtable touched on early successes and stumbling blocks; the impact of the ACA on contemporary oncology practice and the new risk pool facing providers, payers, and patients; and some of the current and future challenges that lie ahead for all.

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Thomas A. D’Amico, Lindsey A.M. Bandini, Alan Balch, Al B. Benson III, Stephen B. Edge, C. Lyn Fitzgerald, Robert J. Green, Wui-Jin Koh, Michael Kolodziej, Shaji Kumar, Neal J. Meropol, James L. Mohler, David Pfister, Ronald S. Walters and Robert W. Carlson

Although oncology care has evolved, outcome assessment remains a key challenge. Outcome measurement requires identification and adoption of a succinct list of metrics indicative of high-quality cancer care for use within and across healthcare systems. NCCN established an advisory committee, the NCCN Quality and Outcomes Committee, consisting of provider experts from NCCN Member Institutions and other stakeholders, including payers and patient advocacy, community oncology, and health information technology representatives, to review the existing quality landscape and identify contemporary, relevant cancer quality and outcomes measures by reevaluating validated measures for endorsement and proposing new measure concepts to fill crucial gaps. This manuscript reports on 22 measures and concepts; 15 that align with existing measures and 7 that are new.