Another key factor to reducing variability was getting physicians to complete their documentation more quickly. The EHR and custom software overlay solved some of barriers to increasing turnaround time, which Sprandio says is now down to a day and a half. That's down considerably from 2006 when he says it was taking 20+ days to get doctors to turnaround their documentation on a patient.
But, Sprandio is quick to say that his organization's model of care is not an easy path to the question of how to transition into a reimbursement model that isn't fee-for-service. He believes strongly in the PCMH standards. While CMOH was the first oncology practice to achieve PCHM Level 3 certification, Sprandio says his practice is now working toward a NCQA certification developed in 2013 for specialty practices, Patient-Centered Specialty Practice Recognition.
Sprandio is also part of a consortium of healthcare leaders examining a national approach to bundling cancer care. He's already participating in an alternative payment method with one insurer, and hopes more insurers decide to offer the same.
"We [CMOH] have what we call an oncology PCMH with Aetna and there's a shared savings component," says Sprandio. "I would maintain that oncology bundling of any kind really requires the foundation or insertion of PCMH standards as a safety net to make sure that patients are advised in the right way."