Message from new COA President, Patrick Cobb, MD

Dear Community Oncology Colleagues: 



I want to acknowledge the Board of Directors of the Community Oncology Alliance (COA) for their support in electing me to the position of President of COA. Fortunately, we have a very involved Board that takes the responsibilities of governing COA very seriously, and collectively is a group of individuals seriously committed to preserving and fostering the community oncology delivery system. 



I especially want to extend my sincere gratitude to Dr. Mac Barnes for his leadership this past year. As President of COA, Mac sacrificed an extraordinary amount of time traveling to Washington, DC and participating in a range of Board, Executive Committee, and various committee calls/meetings. Mac is always there for community oncology and now joins the list of past COA Presidents — Kurt Tauer, Lennie Kalman, and Fred Schnell — who are still giving their time and hearts to community oncology. This will be one tough act to follow! 



Why take on being President of COA? 



I believe that COA as the advocacy organization for community oncology is more important than ever before. Just a week ago I was with our lobbying team on Capitol Hill meeting with members of Congress and staff. Although we have many supporters in Congress, there are still those members and staffers who do not understand the crisis unfolding in community oncology. With the prospect for major healthcare reform very likely this year or next, community oncology has to be proactive and aggressive in shaping this reform before it swamps us. I can assure you that COA will lead the way with its sole focus — protecting and enhancing the community oncology delivery system. 



A week does not go by when we hear of yet another community oncology practice either closing or considering it. Although this appears to be especially impacting our colleagues in smaller practices, I know of larger practices laying off staff and closing satellite facilities. We have experienced this firsthand in my practice as we had to close one of our offices serving a rural area. Unfortunately, those most impacted by the pressures on our practices are those least able to bear the burden — our patients. Now, with the economic crisis, there are reports of more patients foregoing treatment. This is simply unacceptable. 



What is COA doing? 



COA is pushing harder than ever to secure relief from the Medicare reimbursement cuts and to advance proactive solutions. For the first time, key organizations on the provider and distributor sides have come together in forging a coalition to secure legislation that would eliminate prompt pay discounts from the calculation of Average Sales Price (ASP). This is important because it impacts Medicare reimbursement and those payers reimbursing for drugs based on ASP. COA has been in the forefront of forming this coalition and in pressing the Congress for prompt pay legislation. 



Second, COA has launched a landmark study to identify and quantify the clinical and operational components of delivering cancer care. All other attempts at capturing the practice expense in oncology have failed because they are not specific to oncology and are not designed to measure the complexity of the services we provide. We are already using preliminary knowledge gained in this Components of Care study to shape legislation for a demonstration project on quality and for securing payment for unreimbursed services such as treatment planning. Additionally, we have launched another major study dealing with the barriers that exist in using oral cancer drugs. 



It’s important to understand the government’s push towards payment for quality in medicine. In addition to incentive payments for PQRI reporting and use of E-Prescribing, the Congress has included language in the proposed $825 billion stimulus bill that would pay physicians for employing health information technology. A summary of this can be found on the COA website at http://www.communityoncology.org under Breaking News. COA is pushing for additional payments for quality cancer care delivery based on evidence-based guidelines. We want to proactively shape policy that provides realistic reimbursement for community oncology.



Third, COA has hired a public relations firm and an individual to head up our patient advocacy efforts. The story of community oncology is completely hidden from the public. Certainly, the crisis we face receives little attention from the press, but we are going to change that. Additionally, COA is going to provide a resource for patients to better understand why their cancer care is being impacted and to find help from the pressures they face. 



Fourth, COA is committed to unifying community oncology and providing practices with resources to help them navigate these difficult times. Among other initiatives, COA will soon launch a special website for community oncology practice administrators as part of networking practices for greater information sharing. United we stand, divided we fall. 



Finally, I want to encourage you to support COA, both with your time and funding. Trust me, as a practicing community oncologist I understand the pressures on time and money. However, no one is going to fight for us like those of us in actual community oncology practice. There have never been more individuals and practices actively involved with COA. Your funding is allowing us to increase our lobbying, public relations, patient advocacy, and data gathering efforts, which are all critical in our fight for our patients. 



During this year it will be essential that you reach out to your Members of Congress. This is a new Congress and an entirely new Administration. As a community, we have to make them aware of the cancer care crisis and the urgent need to address it before it is too late. COA will be providing you with more information and materials for you to use in getting everyone in your practice involved in these outreach efforts. 



If you have any questions, comments, or want to get more involved, you can contact me by accessing my contact information on this website.

Sincerely,

Patrick Cobb, MD 

President