CMS National Quality Strategy Focuses on Quality, Safety, Affordability Standards in Oncology Care

Lee Fleisher, MD, Chief Medical Officer for the Centers for Medicare and Medicaid Services (CMS), and Director of the Center for Clinical Standards and Quality at CMS, discusses the basis and goals of CMS’ National Quality Strategy.

Transcript

My name is Lee Fleisher. I'm the Chief Medical Officer for the Centers for Medicare and Medicaid Services, and I'm also the director of the Center for Clinical Standards and Quality at CMS. I also am Professor Emeritus of Anesthesiology and Critical Care at the University of Pennsylvania.

How is CMS defining value within its current strategy?

We're very focused on high-quality care, that it's safe, that it provides excellent care, that it's equitable, most importantly, as well as affordable. But those three components of quality, that safety, quality and equitable, among all patients is critical.

What are the biggest challenges for oncology care in the next 5 to 10 years?

I think really for all care, and oncology care certainly is one of the areas of specialty care that's so important, is really that we ensure that all individuals get that same high quality care in this resilient system, which is as we're in the endemic phase of the coronavirus infection. And that we really ensure that we think about the social needs, which show impact, the ability to have good clinical outcomes, which is part of the new enhanced oncology model, that we address those social needs, not necessarily by the system, but we refer individuals to many of those non-governmental organizations because of that interaction between medical care and social needs.

How will CMS’s vision and National Quality Strategy address these challenges?

As part of the National Quality Strategy, which we put out over the last year, we really have eight fundamental pillars that lead off of the administrator, Chiquita Brooks-LaSure, six fundamental pillars, and that really starts with ensuring equity for all and ensuring access to high-quality care for all. And in the national quality strategy, we really want to look at the entire journey throughout life, from birth to death, and certainly for oncology, that quality of life, both as you're being treated and hopefully cured. But also for those non-curable events, how that quality continues to end-of-life care, which is some of the hallmarks of the new enhanced oncology model. How to think about that. And really ensuring alignment between all of the payers in the system, ensuring that how we measure quality is done in a very similar way using aligned measures.

And lastly, we think a lot about digital health and thinking about digital quality measures. We talked during the talk today about fire as well as APIs, application program interfaces, and the ability to really pull down the information and share it across the entire healthcare ecosystem. Because one of the goals at CMS right now is that everybody is in an accountable care relationship, not necessarily an ACO, but that's one of the ways to do that, in which there really is somebody in charge of your care. And as you see in the enhanced oncology model, they talk a lot about navigators that really, that journey is quarterbacked by a particular person. Now, it could be a primary caregiver, but in fact, for many patients who have complex cancer, it could be the oncologist.