CMS Oncology Care Model Names NCCN Guidelines as High-Quality Care and Evidence-Based Recommendations
On February 12, 2015, Centers for Medicare & Medicaid Services Innovation (CMS Innovation Center) announced an Oncology Care Model (OCM) with the goal to utilize appropriately aligned financial incentives to improve care coordination, appropriateness of care, and access to care for beneficiaries undergoing chemotherapy.1
To participate in the OCM, participating practices will be required to treat patients with therapies consistent with nationally recognized clinical practice guidelines, such as those published by NCCN and ASCO, reporting both when patients are and are not treated in concordance with such recommendations. One reason for deviation from clinical guidelines, according to CMS, is participation in a clinical trial.2 Participation in clinical trials is considered concordant care with the recommendations in the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines).
“NCCN applauds CMS Innovation Center’s new payment and delivery model as it directly aligns with the NCCN mission to improve the quality, effectiveness, and efficiency of cancer care so that patients can live better lives,” said Robert W. Carlson, MD, Chief Executive Officer, NCCN. “Today, NCCN publishes the most comprehensive, transparent, and current clinical practice guidelines in oncology, providing clinicians and patients with evidence-based recommendations in order to make informed choices relating to cancer care.”
“The decision to endorse the NCCN Guidelines indeed further establishes CMS’ identification of NCCN as an arbiter of high value oncology care, adding to their recognition of the NCCN Drugs & Biologics Compendium as an authoritative reference for oncology policy coverage,” said Dr. Carlson.
According to CMS, a majority of the 1.6 million people diagnosed with cancer each year in the United States are over the age of 65 and Medicare beneficiaries; through OCM, CMS strives to achieve 3 goals for that population: better care, smarter spending, and healthier people.
“For 20 years, NCCN has convened multidisciplinary experts from the nation’s top cancer centers to promote the importance of continuous quality improvement,” said Dr. Carlson. “NCCN Guidelines recommendations are the standard of oncology care in the United States, and we encourage practices to participate in OCM and further high-value, evidence-based cancer treatment.”
NCCN publishes a library of 60 NCCN Guidelines—a comprehensive set of guidelines detailing the sequential management decisions and interventions that currently apply to 97% of cancers affecting patients in the United States. In addition, separate guidelines provide recommendations for some of the key cancer prevention and screening topics, as well as supportive care and age-related considerations. The NCCN Drugs & Biologics Compendium, a derivative of the NCCN Guidelines, is recognized by public and private insurers alike, including, but not limited to CMS, as an authoritative reference for oncology coverage policy.
For more information about the NCCN Guidelines, visit NCCN.org.
Looking Back on 2 Decades of Breast Cancer Treatment: Targeted Therapy and Improved Surgical Procedures are Key Enhancements
Breast cancer is the most frequently diagnosed cancer globally and the leading cause of cancer-related death in women. However, the incidence of breast cancer has somewhat stabilized over the past few decades, and breast cancer mortality appears to be declining,3 suggesting a benefit from the combination of early detection and more effective treatment.4
NCCN has published the 20th annual edition of the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines) for Breast Cancer—one of the original NCCN Guidelines published in November 1996.
“It is fascinating to look back at the original NCCN Guidelines for Breast Cancer—so many things have changed,” said William J. Gradishar, MD, Professor in Medicine – Hematology/Oncology, Robert H. Lurie Comprehensive Cancer Center of Northwestern University, and Chair of the NCCN Guidelines Panel for Breast Cancer. “An incredible amount of progress has been made in surgical procedures and treatment based on tumor characteristics.”
From a surgical standpoint, said Dr. Gradishar, axillary lymph node dissection was the standard of care in 1996. Today, the less invasive sentinel lymph node (SLN) biopsy is the standard of care for patients with early-stage breast cancer to determine spread of the disease, which has removed the risk of unnecessary extensive lymph node removal and has decreased the risks of postsurgical complications.5
“How we thought about adjuvant therapy has changed,” said Dr. Gradishar. “Physicians used to look at the number of nodes as a determinant of whether a patient was a candidate for chemotherapy, as well as what kind of chemotherapy was appropriate. Now we use genomic profiling to influence our decision-making. Additionally, the chemotherapy regimens have changed and endocrine therapy options have expanded, as has the duration of therapy.”
Indeed, genomic testing and targeted therapies have changed the course of breast cancer treatment. In particular, according to Dr. Gradishar, 20 years ago human epidermal growth factor receptor (HER2)-positive disease was not listed in the guidelines, and today the NCCN Guidelines recommendations include a cadre of successful neoadjuvant and adjuvant chemotherapies for people with HER2-positive disease.
“As the founding chair of the NCCN Guidelines Panel for Breast Cancer, I am especially pleased to announce the 20th annual edition of the NCCN Guidelines for Breast Cancer,” said Robert W. Carlson, MD, Chief Executive Officer, NCCN, and Former Chair of the NCCN Guidelines Panel for Breast Cancer. “Over the past 2 decades, the global focus on breast cancer has grown exponentially and with the expertise and experience of the NCCN Guidelines Panel, oncologists around the world have consistently had access to high-quality, high-value treatment recommendations.”
In addition to the NCCN Guidelines for Breast Cancer, NCCN also offers the following resources for clinicians and patients: NCCN Guidelines for Breast Cancer Risk Reduction, NCCN Guidelines for Breast Cancer Screening and Diagnosis, NCCN Guidelines for Genetic/Familial High-Risk Assessment: Breast and Ovarian, and NCCN Guidelines for Patients: Breast Cancer (Stages 0–IV).
Today, NCCN develops and maintains 60 NCCN Guidelines, covering 97% of malignant cancers affecting people in the United States. The NCCN Guidelines are developed and updated through an evidence-based process in which the expert panels integrate comprehensive clinical and scientific data with the judgment of the multidisciplinary panel members and other experts drawn from NCCN Member Institutions. Access to the complete library of NCCN Guidelines is available free-of-charge at NCCN.org.
In January, NCCN celebrated its 20th anniversary and on March 12–14, 2015, NCCN will host its 20th Annual Conference: Advancing the Standard of Cancer Care at The Diplomat in Hollywood, Florida. In recognition of its 20th anniversary, NCCN will host a special live roundtable during the conference featuring NCCN leadership—past and present—as well as other stakeholders who have had a significant impact on the development, progressions, and success of NCCN over the years. Noteworthy historical NCCN accomplishment and events will be discussed, as well as the impact NCCN has had and continues to have on the quality, effectiveness, and efficiency of cancer care so that patients can live better lives.
To learn more about NCCN, the NCCN Guidelines, and the NCCN 20th Annual Conference, visit NCCN.org.
3. Siegel RL, Miller KD, Jemal A. Cancer statistics, 2015. CA Cancer J Clin 2015;65:5–29.
4. Gradishar WJ, Anderson BO, Balassanian R, et al. NCCN Clinical Practice Guidelines in Oncology: Breast Cancer. Version 1, 2015. Available at: NCCN.org. Accessed February 10, 2015.
On January 31, 2015, NCCN celebrated its 20th anniversary. Originally announced as an alliance of 13 leading cancer centers in 1995, NCCN has grown to a network of 25 academic cancer centers; the NCCN mission as an alliance of leading academic cancer centers devoted to patient care, research, and education, is to improve the quality, effectiveness, and efficiency of cancer care so that patients can live better lives.
“NCCN is thrilled to commemorate 20 years of defining and advancing high-quality, high-value cancer care and we are both honored and humbled by the opportunity to serve our Member Institutions and patients,” said Robert W. Carlson, MD, Chief Executive Officer, NCCN. “For 2 decades, the NCCN Guidelines have been recognized as the standard of cancer care in the United States, combining evidence, experience, and choice so that multidisciplinary cancer treatment teams—including patients—are empowered to make informed decisions about cancer care.”
Core to the advancement of the NCCN mission is the NCCN Guidelines program. In November 1996, NCCN published the first NCCN Guidelines, covering 8 cancer types. Today, NCCN publishes 60 NCCN Guidelines that are a comprehensive set of guidelines detailing the sequential management decisions and interventions that currently apply to 97% of cancers affecting patients in the United States. In addition, separate guidelines provide recommendations for some of the key cancer prevention and screening topics, as well as supportive care and age-related considerations. The NCCN Guidelines are continuously updated and are available free-of-charge to clinicians and patients on NCCN.org, as well as through the NCCN Virtual Library of NCCN Guidelines mobile app; in 2014, more than 6 million copies of the NCCN Guidelines were downloaded from these NCCN resources.
Derived from the NCCN Guidelines, the NCCN Drugs & Biologics Compendium, the NCCN Chemotherapy Order Templates, and the NCCN Biomarkers Compendium, are clinical resources formatted for ease-of-use for multiple stakeholders. The NCCN Compendium is officially recognized by CMS, Cigna, and UnitedHealthcare as a mandated reference in creation of coverage policy and coverage decisions. Further, NCCN collaborates with health information technology organizations to ensure that NCCN clinical resources are contained in these tools and are available to clinicians, payers, and other health care professionals.
To enhance its commitment to patients, NCCN, with the support of the NCCN Foundation, published the first NCCN Guidelines for Patients in 2010, providing a patient-friendly translation of the NCCN Guidelines for Breast Cancer. Since then, the library of NCCN Guidelines for Patients has grown to include 14 disease types that are available free-of-charge on NCCN.org/patients.
In recognition of the essential role of research in advancing cancer therapies in order to improve the quality of life for patients and reduce cancer-related deaths, the NCCN Oncology Research Program (ORP), was established in 1999. The NCCN ORP supports oncology preclinical, translational, and clinical research at NCCN Member Institutions; to date, more than $50 million in research grants have been secured and distributed to investigators from NCCN. It is NCCN’s vision to have the NCCN ORP become a Center for Excellence in the United States for providing outstanding research and research services.
NCCN has also enriched an already well-established education program with an online learning management platform, providing oncology clinicians with expanded and easy-to-access continuing education opportunities based on NCCN content. Each year more than 175 NCCN continuing education programs are conducted for medical professionals around the world. Moreover, NCCN offers a certificate program—NCCN International Educational Activities Program—that recognizes physicians outside the United States for completion of NCCN educational content hours.
On March 12–14, 2015, NCCN is hosting its 20th Annual Conference: Advancing the Standard of Cancer Care at The Diplomat in Hollywood, Florida. In recognition of its 20th anniversary, NCCN will host a special live roundtable during the conference comprised of NCCN leadership—past and present—as well as other stakeholders who have had a significant impact on the development, progression, and success of NCCN over the years. Noteworthy historical NCCN accomplishments and events will be discussed, as well as the impact NCCN has had and continues to have on the quality, effectiveness, and efficiency of cancer care so that patients can live better lives.
To learn more about NCCN, NCCN history, or the NCCN 20th Annual Conference, visit NCCN.org.