Thriving in a Value-Based Care World
Creating a Positive Patient Journey
The Power of Effective Communication in Oncology and Patient Care
Case Study: Zangmeister Cancer Center
EMPLOYEE SPOTLIGHTS: Kembly Mourelo and Karina Wischhusen, RN
Our pharmacy teams' expertise is essential to providing exceptional patient care. We are grateful for their hard work and contributions to the industry and our patients.
Healthcare is a constantly evolving landscape. As a result, we must stay informed about the latest industry trends and news that guide the way we practice and provide patient care. This extends to our experienced, compassionate pharmacy teams that provide services and deliver critical medications to our patients nationwide.
Oncology pharmacy is a complex field, facing challenges such as the rising power of pharmacy benefit managers (PBMs), payer policy changes, value-based care initiatives, drug shortages, increasing government regulations, the growing availability of biosimilars, 505(B)(2) alternatives and the introduction of novel drug therapies. Our AON pharmacy teams are poised to lead the way, addressing challenges, seizing opportunities, and providing expert guidance and solutions.
The teams work collaboratively with our physicians and all other stakeholders through AON’s Pharmacy and Therapeutics Committee (P&T) to provide clinical guidance for the practice. The committee evaluates all therapies based on efficacy, tolerability and value. The guidance is shared through weekly emails, text blasts, our Formulary Navigator tool and direct interventions by our pharmacy teams.
Our pharmacy teams' expertise is essential to providing exceptional patient care. We are grateful for their hard work and contributions to the industry and our patients. They go above and beyond to ensure the delivery of the highest quality of care, even in the face of challenges.
As we look ahead, we remain steadfast in our commitment to the AON mission. We will continue to navigate the complex paths of oncology and medicine, always seeking new ways to innovate and adapt to ensure we are providing exceptional value to our patients — no matter where they are in their cancer journey.
James Gilmore AON’s Chief Pharmacy & Clinical Services Officer
Chemo Shortage Increases Treatment Costs by 16% for Head and Neck Cancer
Feature: Puneeth Indurlal, MD, MS, MBBS
The cisplatin shortage that occurred resulted in the use of alternative therapies for the treatment of head and neck cancers, which led to significant cost increases for patients and payers, according to findings from a study presented at the 2024 ASCO Quality Care Symposium.
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Improving Luspatercept Dosing for Patients With MDS: The Impact of Pharmacist-Led Interventions at AON
Feature: Brooke Peters, PharmD, BCOP
Pharmacy Times® interviewed Brooke Peters, PharmD, BCOP, clinical pharmacy services manager, pharmacy operations at American Oncology Network (AON) in Fort Myers, Florida, on a study presented at the Society of Hematologic Oncology 2024 Annual Meeting titled: Evaluating the impact of an electronic medical record [EMR] alert on appropriate dosing of luspatercept [Reblozyl; Bristol Myers Squibb] in patients with low-risk myelodysplastic syndromes (MDS) in a community oncology network.
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Keeping Up With Evolving Data to Better Cancer Care
Feature: Stephen “Fred” Divers, MD
With all the practice-changing data coming out at major conferences, it’s getting harder for physicians to keep up and practice medicine, said experts kicking off the second fireside chat on day 2 of the annual Patient Centered-Oncology Care® meeting.
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CPC + CBEx 2024: Managing Clinical & Financial Risk in Oncology
Feature: Alti Rahman, MHA, MBA, CSSBB
A group of oncology practice innovators and care platform disruptors spoke as part of a session at the 2024 Clinical Pathways Congress + Cancer Care Business Exchange about managing clinical and financial risk in oncology.
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Susan Sabo-Wagner Previews Key Themes of PCOC 2024
Feature: Susan Sabo-Wagner, MSN, RN, OCN
The meeting will showcase experts in the oncology space with discussions surrounding recent innovations that target patient care to increase quality of life.
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PCOC 2024 Promises to Hit All the High Notes
Feature: Susan Sabo-Wagner, MSN, RN, OCN
It’s that time of year, when the team at The American Journal of Managed Care® puts the final touches on our best-in-class multistakeholder meeting, Patient-Centered Oncology Care®.
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Revised EOM Offers More Favorable Opportunities for Community Practices, Experts Say
Feature: Susan Sabo-Wagner, MSN, RN, OCN; Anne Marie Rainey, MSN, RN, CHC, CPHQ
Changes to CMS’s Enhanced Oncology Model (EOM) offer community oncology practices more opportunities for compensation and breathing room to try an alternative advanced payment model (APM), despite ongoing requirements to pursue health equity goals, according to experts who appeared on a July 10, 2024, webinar.
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Managed Care Cast Presents: Challenges of Diagnosing and Managing PNH
Feature: Brian P. Mulherin, MD
Today we are bringing you a conversation between 3 experts on paroxysmal nocturnal hemoglobinuria (PNH).
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End of OCM Brings Drop-Off in Value-Based Care Volume, New Questions
Feature: Stephen “Fred” Divers, MD
The end of the Oncology Care Model (OCM) and the financial incentives that came with it have led to significant drops in the volume of care conducted under value-based designs, according to oncology network and practice leaders who offered an update, during the Community Oncology Alliance (COA) 2024 Community Oncology Conference in Orlando, Florida.
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Todd Schonherz Chief Executive Officer
Mark Moch Chief Information Officer
Stephen “Fred” Divers, MD Chief Medical Officer
Karen Pilley Chief Revenue Cycle Officer
Doug Braun Vice President Pharmacy
Puneeth Indurlal, MD Vice President Practice Operations
Melody Chang Vice President Pharmacy Operations
Guy Messer Vice President Radiation & Radiology Services
David Afshar Chief Financial & Operating Officer
Alti Rahman Chief Strategy & Innovation Officer
Anthony Belott Chief Development Officer
Steve Swart Executive Vice President Practice Operations
James Gilmore Chief Pharmacy & Clinical Services Officer
Tena Messer Executive Vice President Practice Operations
Kristin Matisziw Chief Compliance & Risk Officer
Ryan Olson, MD Medical Director Pathology
Michael Essik Vice President Finance
Karen Quick Vice President Human Resources
Katie Goodman Vice President Clinical Research
Susan Sabo-Wagner Vice President Clinical Innovation
Kyle Hendrickson Vice President Mergers & Acquisitions
Caroline Hewitt Vice President Marketing
By: MiBA Leadership
At MiBA, we never lose sight of what matters most — the patient.
We are Meaningful Insights Biotech Analytics (MiBA), and we're a revolutionary healthcare technology company redefining the landscape of patient care and medical research. Our mission is to advance healthcare quality through actionable, data-centered intelligence, bridging gaps and empowering better outcomes for all stakeholders in the healthcare ecosystem.
At our core, we're visionaries creating a future where data informs every step toward cancer care. Led by a team of seasoned experts in data science, oncology and healthcare technology, we envision a future where data-driven insights lead to transformative improvements in patient care and treatment efficacy.
Our leadership brings together a wealth of experience, setting new standards at the intersection of healthcare and technology. This collective expertise forms the backbone of our innovative approach to revolutionizing the oncology space.
We simplify the complexities of oncology data by curating and applying AI technologies to extract meaningful insights accelerating advancements in cancer care and patient outcomes.
Our AI-powered technology serves as a central hub, bringing together various stakeholders in the healthcare industry:
CARET-RIGHT We provide physicians with access to real-time, quality data-driven insights and education to inform treatment decisions and personalize care.
CARET-RIGHT We offer industry partners valuable and accurate data insights to support research and development.
At the heart of our offering is our ability to generate and analyze vast amounts of healthcare data. We collect and process various types of data, including:
• Electronic health records
• Practice management (claims data)
• Specialty pharmacy
• Clinical trial
• Genomic and molecular data
By applying advanced analytics and AI algorithms, we uncover patterns, trends and correlations that can significantly improve patient care and drive innovation.
Above all, patients are at the core of our mission. By facilitating more informed decision-making and personalized treatment plans, we help improve patient outcomes and quality of life. Our focus on patient-centered data ensures that every insight generated has the potential to make a real difference in people's lives. Our patient-centered approach creates a ripple effect of benefits across the entire healthcare ecosystem.
What sets us apart in the competitive oncology technology and insights landscape?
1. We're the premier data source in oncology. Our precision data approach drives revolutionary advancements in cancer research and care.
2. We have a direct impact on improving patient care. By keeping patients at the center of our mission, we ensure that our innovations translate directly into improved care and outcomes.
3. We provide actionable insights for industry partners. We don't just provide data — we deliver meaningful, actionable intelligence that partners can use to drive real change.
As a result, the company sees a reduction in trial duration and an increase in successful outcomes, accelerating the path to market for a promising new cancer treatment. Introducing MiBA and How We Drive
The impact of our innovative approach is already being felt throughout the healthcare industry. Here are a couple of examples that illustrate the potential of our technology:
A pharmaceutical company partners with MiBA to optimize its clinical trial matching process. By leveraging MiBA's precision data, the company can:
CARET-RIGHT Identify the most suitable patient populations and site selections for the trial.
CARET-RIGHT Predict potential challenges in patient recruitment and retention.
CARET-RIGHT Refine their trial protocols based on real-world patient data (RWD).
An oncology network implements MiBA's AI-powered analytics platform to enhance their oncology care. The results can be transformative:
CARET-RIGHT Physicians are empowered to make more informed decision-making based on precision oncology.
CARET-RIGHT Physicians have access to clinical decision support (TIPS).
CARET-RIGHT Reduced cost of care throughout the patient journey.
CARET-RIGHT Patient outcomes can significantly improve.
These examples only scratch the surface of what's possible with our technology, and we are continuing to innovate and expand our offerings.
The healthcare industry stands at a pivotal moment, with the power of AI and data analytics opening up unprecedented opportunities for improvement and innovation. We're at the beginning of this transformative journey.
Whether you're a healthcare provider looking to enhance patient care, a pharmaceutical company seeking to accelerate drug development, or a research organization aiming to push the boundaries of medical knowledge, we have the tools and insights to support your goals.
As we look to the future, the potential for AI-driven healthcare solutions is vast. With MiBA leading the way, we can anticipate a world where treatments are more targeted, research is more efficient, and patients receive truly personalized care. The journey to transform healthcare through precision data has just begun, and we're proud to be at the forefront of this exciting revolution.
To learn more about how we can empower your organization and contribute to the advancement of precision oncology care, visit www.mibanalytics.com or reach out to our team of experts.
Together, we can turn data into breakthroughs and shape the future of cancer care.
The healthcare industry has undergone a seismic shift since the late 1960s, moving from a fee-forservice (FFS) model to one centered on valuebased care (VBC). The paradigm shift emphasizes the quality of care, patient outcomes and cost-efficiency over the traditional volume-based approach. While this shift promises improved patient experiences and healthcare affordability, it presents unique challenges for private practices that sometimes require additional support from organizations like the American Oncology Network. Balancing the demands of delivering high-quality care with the structural pressures of VBC requires a strategic approach extending beyond the practice’s walls.
To thrive in this new landscape, private practices must actively participate in community and national VBC programs, understanding the new payment model and learning how to implement it with as minimal disruption as possible to patient care. By collaborating with other healthcare providers, payers and community organizations, practices can leverage shared resources,
reduce costs and improve patient health and outcomes. Additionally, implementing VBC strategies within the practice, such as patient engagement, care coordination and data analytics, is essential to achieve long-term success and community oncology viability.
Rising healthcare costs and declining care quality spurred the development of VBC. The potential benefits of this model for improving patient care are substantial, and the larger healthcare industry has begun to move toward this approach through policy changes and payment reforms even though the traditional fee-for-service model is still used. As a result, providers are increasingly compelled to transition to VBC models to align with this evolving landscape. For example, the Centers for Medicare and Medicaid Services along with private payers have begun updating policies to center around quality and provide associated incentives to support the transition away from FFS models.
Despite the promise of VBC, many providers in the healthcare industry have been slow to adopt this model
fully. A Deloitte study from 2020 revealed that the majority of providers — 97% to be exact — were still using the FFS payment model or receiving a straight salary, with 36% receiving compensation from valuebased payments. Moreover, the study outlined the challenges of incorporating social determinants of health into nonclinical care decisions, with only 73% of providers considering these factors and 46% accessing relevant economic and community data for their patients.
The transition to VBC presents substantial obstacles for many private practices that cannot be overlooked and need to be addressed. Providers contemplating this shift are confronted with several challenges that can be hard to overcome. Financial risk is a primary concern, as patient outcomes can fluctuate and reimbursement is not immediate, delaying provider payment and potentially straining capacity and resources. Additionally, establishing reliable and appropriate metrics to benchmark care quality while ensuring consistent data collection can be overwhelming. The substantial investment in healthcare technology required for tracking and reporting VBC outcomes further complicates the process. Finally, reconciling the shift from FFS to VBC reimbursement models poses significant financial and administrative challenges.
However challenging the move to the new payment models is, the benefits of becoming a VBC practice are significant. The Commonwealth Fund Organization emphasized that one of the greater benefits is that providers are able to deliver the right care to their patients at the right time. Additionally, healthcare costs may decrease; patient outcomes, satisfaction and engagement may improve; and better care coordination may transpire from the increased collaboration between providers and care teams. Ultimately, providers can return to delivering patientcentric care instead of a volume-based services approach.
The transition from traditional models to VBC can be strenuous, but with the right resources and support, private practices can make the move. According to the American Medical Association, practices need to execute on key VBC elements: providing high-quality care that is safe, timely, effective, efficient, equitable and patient-centered (STEEEP). It further stresses the importance of improved patient outcomes and satisfaction, lower costs, provider and health professional well-being, and health equity.
73% of providers consider social determinants of health in nonclinical care decisions
46% of providers access relevant economic and community data for patients
There are four VBC payment models according to Deloitte:
• Performance-based payments.
• Bundled payments.
• Shared savings and risk.
• Capitation.
Health insurance companies play a pivotal role in the transition to and success of VBC in hospitals and practices nationwide. As they were key players in the fee-for-service reimbursement model, they hold a similar role in VBC movements. Under the traditional FFS payment model, payers reimbursed providers for every medical care or service provided, leading to the potential overutilization of services because of the incentive's structure, and they bore the financial risk because the cost of care widely varied.
Now, payers are reimbursing providers based on quality and outcomes, delivering even bonuses and penalties based on performance. Payers emphasize patient outcomes through the importance of preventive and coordinated care as essential measurements of VBC success. Lastly, the financial risk has shifted and is now shared between payers and providers.
VBC is not a universal payment model. Payers are using both payment models for various reasons:
• Competitive pressures and market dynamics set by regulatory changes and market demands.
• Providers’ ability to participate in VBC models.
• Various payer risk tolerances.
• Inability to implement the required technology and data infrastructure.
Providers should strive to cultivate positive relationships with payers given their important role in the VBC transition. This can lead to more favorable contract negotiations, potentially higher reimbursement rates and improved practice success.
Transitioning to a VBC model ensures that patient care remains at the forefront of the practice and care delivery model. According to Productive Edge, here are several actionable steps to help practices transition to value-based care.
Establish a strong commitment to VBC and learn more about it.
The move to a VBC model necessitates fundamental changes within the practice, including revised payment systems, updated processes and policies and new software for tracking key metrics. It also impacts how providers and care teams approach patient care. To successfully navigate this transition, practices can begin by firmly committing to VBC and thoroughly understanding its complexities and the cultural alignment required of key internal stakeholders, physicians, nurses and other staff members. Explore resources from reputable organizations like the National Institute of Health and the Centers for Medicare & Medicaid Services. Lastly, connect with VBC experts, such as the American Oncology Network and Community Oncology Alliance, for valuable insights and guidance.
Develop a VBC-aligned strategic business plan.
A strategic business plan originally designed for FFS must be thoroughly revised to align with the VBC model and its unique reimbursement strategies. The new plan should clearly outline practice goals, objectives and specific timeliness with the VBC rollout and other key milestones. This is a crucial roadmap, guiding practices through the transition process with actionable steps and clear deadlines.
Communicate VBC commitment and foster adoption.
Once the commitment to VBC is made and the business plan finalized, the next step is to inform and align all stakeholders, including care teams and third-party partners. While growing pains are inevitable during the transition, embracing these challenges can strengthen the VBC commitment and ultimately benefit patient care. As a change agent, lead the way in championing this new model and care approach. Prioritize strong, transparent and concise communication to address questions and concerns from stakeholders.
Educate staff and care teams on VBC at the practice.
A new model may present challenges for staff and care teams, and they may struggle with understanding or adopting it. Provide additional resources on VBC and update policies and procedures to support the transition and new ways of operations and patient care. Share concrete examples of how care teams can integrate VBC activities into their daily responsibilities. Storytelling can be a powerful tool for helping teams grasp new concepts.
Leverage available health information technology, such as electronic health records (EHR) and other advanced analytics, for VBC success.
It is important to capture VBC-related data and streamline operations by investing in the right technology. This can help ease the transition and ensure key metrics are monitored and met. According to Tech Target, essential tools include:
• Health information exchange.
• Population health management tools.
• Data analytics.
• Artificial intelligence and machine learning tools.
• Price transparency technology.
A promising example of one tool is Meaningful Insights Biotech Analytics or MiBA. This cutting-edge advanced analytics company specializes in precision data for cancer research and care. MiBA offers valuable features like clinical trial identification, market insights, improved patient tracking and predictive modeling among other services.
Invest in care coordination and a collaborative care approach.
The VBC model prioritizes patient health outcomes. Care coordination is essential to streamlining patient care across various providers and teams, ensuring a seamless experience. Investing in care coordination processes is crucial for VBC success. A dedicated care coordination team can assist patients throughout their health journey, from diagnosis to post-treatment care and support. They can also provide proactive support, such as connecting with patients between appointments and offering guidance on nutrition. As cancer peridiagnostic delivery models (primary care, accountable care organizations, clinically integrated networks) invest in care coordination, there is tremendous potential to sync care coordination services along the spectrum of the consumers' health journey.
Realign focus on preventive and patientcentric care.
The VBC model rewards good patient health outcomes and emphasizes preventive care to reduce hospital admissions. Preventive care, including screenings, annual check-ups and immunizations, should be a routine part of patient care — no matter the specialty. Providers should advocate for preventive care and ensure patients are actively participating. This is another example of how care coordination teams can support patients and ensure they receive necessary preventive services.
Identify and measure robust VBC performance metrics.
Measuring success in VBC requires tracking appropriate metrics for provider evaluation and payer reimbursement. Key quality and outcome metrics include:
• Preventable infections and other disease rates.
• Patient readmission rates.
• Patient satisfaction scores.
• Chronic disease management scores.
• Cancer screening rates.
• Access to care, including time to doctor/appointment and time to treatment.
Cost metrics, such as total care costs, are also important to track. When selecting metrics, focus on categories related to effectiveness, efficiency, timeliness, safety, patient focus and equitability.
Establish a solid risk management strategy.
Transitioning to VBC introduces financial risks that require a robust risk management strategy. Key components of this strategy include the following sections:
• Risk analysis: Identify, assess and then prioritize potential financial risks, such as coding errors, delayed payments and improper billing.
• Risk mitigation: Negotiate risk-sharing contracts with payers, purchase insurance to help protect the practice and provider, and develop a cash flow management plan.
• Financial management: Create a doable contingency plan and leverage financial modeling tools.
• Compliance: Implement strong compliance programs and internal processes to ensure adherence to VBC requirements.
Embrace continuous improvement to improve VBC at the practice.
With a solid business plan and strategy, practices must continuously evaluate their VBC performance to ensure they are properly reimbursed. Leverage data reports and tools to assess progress against VBC requirements. Implement continuous quality improvement (CQI) plans, such as the popular Plan-Do-Check-Act, Baldrige Criteria and Six Sigma techniques, to highlight issues, develop solutions and measure results.
As a reminder, practices’ success in VBC depends on several factors: strong leadership, effective team collaboration across specialties and departments, leveraging appropriate technology tools to measure data, and a commitment to continuous learning about the VBC models and their implementation.
AON is at the forefront of driving VBC initiatives within the oncology landscape. By leveraging its deep expertise and innovative solutions, AON is helping community oncology practices navigate the complexities of VBC transitions. This includes providing comprehensive support in areas such as risk-based contracting, quality improvement, population health management and basic administrative and operational tasks. AON’s collaborative approach empowers providers to optimize patient outcomes, enhance operational efficiency and thrive in the evolving healthcare landscape.
AON has formed strategic partnerships with leading healthcare organizations to remain at the forefront of VBC and further support community-based oncology practices across the nation.
One such example is its recent partnership with Vantage Health Technologies, part of global healthcare social enterprise, BroadReach Group, to offer community oncology providers an AI-enabled platform that provides real-time health data for actionable insights and nextbest-actions that promote better patient experiences and outcomes, reduce provider burnout and lower the cost of care. The platform promises to further enhance AON’s VBC model in community oncology by ensuring providers have access to actionable data that offers a holistic, real-time picture of patients, so they can meet them where they are and help them make better-informed decisions. It will offer providers the information they need to deliver exceedingly personalized and effective care to improve patient experiences and outcomes, reduce the cost of care for the entire ecosystem and ultimately further AON’s ability to provide an exceptionally high-quality experience for all.
Phase one of the partnership, at the end of 2024, will harness Vantage’s SocialHealth360 solution to enhance patient navigation and care coordination services, with an
emphasis on addressing social determinants of health (SDoH), such as housing, food security, transportation and health literacy, which studies show drive up to 80% of health outcomes for vulnerable patients. Subsequent phases of the partnership will focus on applying AI solutions to operationalize upstream and downstream VBC use cases.
“Value-based care is the future of healthcare, offering a path toward more accessible, affordable and effective care,” said Alti Rahman, AON’s chief strategy and innovation officer. “At AON, we understand that the cancer journey is a complex set of socioeconomic, behavioral and genetic factors that are part of the individual life journey. That journey is unique to the local communities in which our high-quality practices operate. AON's leadership team aims to continuously improve and demonstrate the criticality of our practices in continuing to survive and thrive in the local healthcare community. We are passionate about supporting local practices in their everyday operations and transition to value-based care, helping them embrace the future of healthcare.”
The VBC transition offers significant benefits, including improved patient outcomes, enhanced care quality and greater financial stability but requires a commitment to change and a willingness to adapt. By taking proactive steps and seeking the right support, practices will survive and thrive in the VBC era. However, it does not have to be a solitary journey. Providers do not have to go at it alone and can seek external support from partners like AON, a dedicated supporter of private oncology practices and champion of VBC.
To learn more about how AON can support providers in transitioning to value-based care, visit www.AONcology.com.
Imagine the healthcare journey as a winding path, filled with twists, turns and unexpected obstacles. For patients, navigating this terrain can be overwhelming and fraught with anxiety. The patient journey, a complex and often stressful one, is a critical yet often overlooked aspect of healthcare. From the moment a patient first experiences symptoms and on through their entire health journey, their experience is unique.
To deliver truly exceptional care, providers must become skilled navigators, mapping and improving this journey to create a supportive and empowering experience for every patient. By prioritizing the patient perspective and focusing on creating positive patient journeys, healthcare organizations can enhance patient satisfaction, improve outcomes and foster stronger relationships with their communities.
The patient journey is a deeply personal experience. While many individuals share similar diagnoses or treatment plans, the overall path is uniquely individual. However, the common threads that are present through these journeys offer valuable insights for providers. By understanding the common stages of the patient journey and the potential challenges patients face at each stage, providers can improve care delivery and patient engagement while fostering stronger patient relationships. Even for seasoned providers, a refresher of the patient journey is still valuable and serves as a helpful reminder and opportunity to identify areas of improvement.
1. Recognize symptoms.
Patient notices an abnormal sign or symptom that leads to concerns.
Challenge: Patient feels anxiety about finding and uncertainty of future.
7. Receives test results.
PCP receives test results and shares results with the patient.
Challenge: Patient feels stress receiving diagnosis and next steps.
2. Schedules PCP appointment.
Patient schedules an appointment with their primary care physician (PCP).
Challenge: Possible long wait time for appointment and difficulty getting timely appointments.
3. Attends PCP appointment.
PCP collects information and may recommend tests to get more insights. Challenge: Information gathering and potential delays associated with it.
8. Receives referral to specialist.
Patient is referred to a specialist.
Challenge: Wait time for specialist appointment.
6. Waits for results.
Patient waits for test results from their PCP.
Challenge: Waiting for test results causes anxiety.
5. Takes recommended tests.
Patient attends test session. Challenge: Patient feels anxiety during the testing process.
4. Schedules recommended tests.
Patient schedules additional tests as recommended and if necessary.
Challenge: Scheduling additional tests and wait times associated with having the test.
14. Enters long-term survivorship or hospice.
Patient continues to experience close follow-up care or enters hospice depending on health outcomes.
Challenge: Long-term health management or end-of-life care. Patient feels fear of potential recurrence.
9. Schedules specialist appointment.
Patient schedules an appointment with the specialist.
Challenge: Wait time for specialist appointment.
10. Attends specialist consultation.
Patient meets with the specialist to discuss diagnosis and treatment options.
Challenge: Understanding complex medical information and making informed decisions about treatment options.
13. Enters extended survivorship.
Patient continues to experience close follow-up care between year three and year five posttreatment.
Challenge: Frequent doctor visits and monitoring. Patient feels fear of potential recurrence.
12. Enters early survivorship.
Patient experiences close follow-up care for the first two years post-treatment.
Challenge: Frequent doctor visits and monitoring. Patient feels fear of potential recurrence.
11. Begins treatment. Patient begins treatment under the specialist’s oversight.
Challenge: Patient experiences side effects and challenges of treatment.
The patient journey is complex as illustrated. These frustrations are prevalent across healthcare, not just oncology, and highlight the need for system-wide improvements. There are present bottlenecks and pain points for both providers and patients nestled in with the opportunity to improve care delivery in all specialties. This holistic understanding empowers providers to create more patient-centered and supportive journeys and align with value-based care initiatives. This then becomes a powerful step in the right direction for patient care.
There are present bottlenecks and pain points for both providers and patients nestled in with the opportunity to improve care delivery in all specialties.
The patient journey and patient experience are intertwined; patient experiences are integral to every stage of the journey. The patient experience dives deeper than the journey, encompassing every interaction and touchpoint. As defined by the Agency for Healthcare Research and Quality, the patient experience “encompasses the range of interactions that patients have with the healthcare system, including their care from health plans, and from doctors, nurses, and staff in hospitals, physician practices, and other healthcare facilities.”
A critical component of value-based care and its patientcentered care approach is understanding the patient experience. It has the potential to uncover patients’ personal needs and even values. Startling statistics highlight the need for change and focus. In a study by The Harris Poll and featured by the American Academy of Physician Associates, it discovered that 73% of adults shared that the healthcare system has fallen short of their needs, while 31% state that excessive wait times for appointments are too long — a finding that is very familiar in healthcare. Moreover, 64% desire more provider time and understanding, and 40% fear speaking up during appointments. These findings demand immediate attention. It is time to move forward with these findings and make changes at the practice level to pave the way for impactful changes at the industry level.
64% desire more provider time and understanding 40%
fear speaking up during appointments
Improving the patient journey and experience begins before patients step foot in the clinic. By positively addressing patient needs and expectations, providers can support their patients through each stage. To achieve this, here are several opportunities to consider:
• Prioritize patient feedback: Actively ask patients for feedback on their experiences and document their specific journey to identify areas of improvement.
• Empower patients with knowledge: Offer valuable and accessible resources that support patients at every stage of their care.
• Build strong patient relationships: Provide personalized communication channels and ensure easy access to the practice, whether that is on the phone or in person.
• Streamline the patient experience: For example, implement efficient appointment scheduling, reminder and intake processes to minimize patient frustration and stress.
AON is a collaborative network empowering community oncology practices to thrive and deliver exceptional patient care. By providing essential business support and innovative solutions, AON enables providers to focus on what matters most: their patients. For instance, dedicated care coordination teams play a vital role in addressing the social determinants of health, which are the non-medical factors that impact a person’s health and well-being such as where they live, work and play among other conditions. These factors contribute to 80% of a person’s health, with zip code serving as the most significant predictor of health outcomes. This team can identify the barriers to care, like the lack of affordable housing, food insecurity or limited transportation to and from appointments, and help remove the challenges that keep patients from accessing and benefiting from the care they need. Care coordination teams are designed to offer comprehensive support, from patient management and nutrition guidance to family assistance and survivorship planning and are key players in the patient journey. Strategic partnerships with industry leaders further enhance patient care and experience.
Care coordination teams are designed to offer comprehensive support, from patient management and nutrition guidance to family assistance and survivorship planning and are key players in the patient journey.
Local practices amplify these efforts through innovative initiatives that support the patient journey. Practices may consider launching a COA Patient Advocacy Network (CPAN) chapter for the community and hosting cancer and survivor support groups. These community-driven programs create a supportive environment for patients and their caregivers, fostering resilience and hope.
Understanding and optimizing the patient journey and focusing on the patient experience are how practices align with value-based care and elevate the patient care provided. By placing patients at the center of care delivery and proactively addressing their needs and expectations, providers can create a transformative healthcare experience. Embracing a patient-centric approach is not merely a goal but a strategic imperative for the future of healthcare.
AON practices champion the patient journey by prioritizing overall health and well-being, not just patients’ medical needs. Here are some examples of how practices go above and beyond the standard of care:
Hope Cancer Care of Nevada exemplifies this commitment by launching a CPAN chapter, hosting a Cancer Survivor Night at the Ballpark event and providing monthly support groups.
Zangmeister Cancer Center holds an annual “Inspire, Survive and Thrive Patient Day,” a special event dedicated to supporting patients in their fight against cancer.
Effective communication is the cornerstone of healthcare, yet it is a skill that can be taken for granted in the fast-paced clinical environment. While regularly emphasized in training, the importance of clear and open communication with patients and colleagues cannot be overstated. This cornerstone of multidisciplinary care is essential for optimal patient outcomes.
Tragically, the consequences of miscommunication can be devastating. Case studies are readily available featuring medical mishaps and errors that result from ineffective communication. In 1994, journalist Betsy Lehman succumbed to a fatal overdose of chemotherapy due to a series of communication errors among the care team. This heartbreaking case shows the critical role of effective communication in preventing medical errors. A CRICO Strategies study further emphasizes this point, revealing that communication breakdowns contribute to 30% of malpractice lawsuits.
Given the overwhelming evidence, it is essential to reflect on your own communication practices. Are you consistently prioritizing clear and respectful communication in every interaction?
Effective communication is a three-pronged approach:
1. Clear Language
Clarity avoids any vague language and is specific. It also avoids using jargon or technical terms unless necessary.
2. Concise Language
Concise language removes any unnecessary words and is direct. Get to the point quickly.
3. Empathetic Behavior
Empathetic behavior is by far the most difficult for some and may take time to learn. It is the ability to understand and respond to the other’s emotions, be open to different perspectives even through disagreement, and actively listen.
Effective communication is both logical and essential; however, it remains a persistent challenge across various sectors, including healthcare. The stakes are high in healthcare, where misunderstandings can have severe, even fatal, consequences. The Betsy Lehman case serves as a stark reminder of the catastrophic outcomes that can arise from communication breakdowns.
Prioritizing communication is a fundamental step toward improving patient care. By fostering open and clear dialogue, healthcare providers can build trust, enhance patient satisfaction and reduce human and medical errors. When patients feel heard and understood, they are most likely to share vital information, adhere to treatment plans and ultimately achieve better health outcomes.
Conversely, poor communication can lead to a cascade of negative consequences. Patients may feel alienated, distrustful and uninformed. Additionally, care teams may experience increased workload, higher stress levels and are at greater risk of medical errors.
Effective communication is often assumed to be a given in healthcare, a tactic that is already present in everyday interactions. The reality of patient and colleague understanding can be far more complex. While providers may believe they are conveying information clearly, patients and colleagues may have difficulty understanding or retaining it.
Factors such as anxiety, fear or simply the volume of information presented at a given time can easily impede comprehension. Moreover, they may be reluctant to ask clarifying questions due to embarrassment or a desire to appear knowledgeable.
To mitigate these challenges and bridge the communication gap, practices must invest in communication training, implement standardized protocols and cultivate a culture that values open dialogue. Additionally, active listening is important. It involves fully concentrating on the speaker, understanding their perspective and responding thoughtfully. This requires providers to temporarily set aside their own thoughts and emotions to focus solely on the patient’s or colleague’s message.
Nonverbal cues, such as body language and facial expressions, should also be carefully observed as they can offer valuable insights into the person’s emotional state and level of understanding. By understanding what the patient is not saying but exhibiting helps providers communicate more effectively. As quoted by the “Critical Conversations In Healthcare,” “Listening is not just hearing the words, but truly understanding the patient’s perspective.”
Maintaining a two-way dialogue is another important strategy for effective communication. Patients and colleagues should feel empowered to ask questions, express concerns and share their perspectives without fear of judgment. Even when delivering sensitive information, it is important that you keep the conversation open so that the patient feels comfortable engaging in the discussion.
Additionally, strategies to improve communication and understanding include the following tactics:
• Clarity and compassion: Strive for direct and effective communication, creating a safe space for open dialogue.
• Plain language: Use clear and concise language, avoiding medical jargon (unless necessary).
• Targeted information: Tailor information to the listener's level of understanding, avoiding unnecessary complexity, such as relying on metaphors because they may be confusing.
• Confirmation: Employ techniques like summarizing key points and then asking open-ended questions to verify understanding.
• Reinforcement: Use repetition and even visual aids when necessary to reinforce critical information. Executing the call-and-repeat technique has been proven beneficial when sharing information.
Patient-Specific Techniques
• Comprehensive support: Provide patients with accessible resources that supplement care, like physical materials, online resources and access to care team members who will be joining them on their journey.
• Language accessibility: Ensure effective communication through interpreter services when language barriers exist. Do not rely on family and friends interpreting, because they may even have trouble communicating what is being shared.
• Personalized approach: Employ storytelling techniques to connect with patients on an emotional level and enhance understanding.
When Communication Gets Heated High-stakes conversations in healthcare, such as delivering delicate news to patients or resolving conflicts among providers and care team members, can escalate rapidly. Effective de-escalation techniques are essential for maintaining productive dialogue and preserving professional relationships.
Here are some techniques and reminders:
• Maintain composure: Practice active listening, focusing on understanding the other person’s perspective without interruption. Remember the importance of clear, concise and empathetic communication.
• Nonverbal cues: Use open and inviting body language to convey calm and respect.
• Create space: Allow for pauses in the conversations to de-escalate tension and gather thoughts.
• Validate feelings: Acknowledge the other person’s emotions without judgment.
• Set limits: Clearly define boundaries and end the conversation if necessary to protect everyone’s well-being.
Effective communication is the cornerstone of quality patient care and the bedrock of successful healthcare organizations and practices. It is the foundation upon which trust, understanding and optimal patient outcomes are built. By prioritizing clear, empathetic and patient-centered communication, providers can significantly enhance the overall quality of care, improve patient satisfaction and contribute to a safer and more efficient healthcare system.
Genesis Cancer and Blood Institute
Relocates Mena Clinic to Larger Location; Adds Clinic Day
Local oncology practice relocates to new location and adds additional clinic day to continue providing enhanced cancer care to the Mena community.
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Genesis Cancer and Blood Institute and American Oncology Network Welcome Dr. Brad Baltz and Open Second Location in Little Rock
Board-certified medical oncologist Brad Baltz, MD, joins the physician team.
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Florida Oncology and Hematology and American Oncology Network Open Second Naples Location and Welcome Dr. Deborah Glick
Board-certified hematologist Deborah Glick, MD, joins the physician team.
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Florida Oncology and Hematology and American Oncology Network Open Fort Myers Location and Welcome Dr. Magali Van den Bergh
Board-certified physician Magali Van den Bergh, MD joins the physician team.
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Florida Oncology and Hematology and American Oncology Network Open Naples Location and Welcome Dr. Zanetta Lamar and Dr. Ferdy Santiago
Board-certified physicians Zanetta Lamar, MD and Ferdy Santiago, MD join the physician team.
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Low Country Cancer Care and American Oncology Network Welcome Dr. Stephen Tiley
Board-certified physician Stephen Tiley, DO, joins the physician team.
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New Location, Same Personalized Care: Vista Oncology Relocates Its Shelton Clinic
Local oncology practice moves its clinic to continue providing enhanced cancer care to the Shelton community.
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Indianapolis Medical Oncologist Co-authors Research Presented at International Lymphoma Symposium
Hematology Oncology of Indiana’s M. Sarfraz Nawaz, MD, investigated improvement in approaches to febrile neutropenia in cancer patients.
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Genesis Cancer and Blood Institute and American Oncology Network Welcome Dr. Jim Chen
Board-certified physician Jim Chen, MD, joins the physician team.
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American Oncology Network Expands Radiation Oncology Services, Opens New Clinic
Low Country Radiation in Waycross provides residents access to advanced radiation oncology care.
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Chen, MD Genesis Cancer and Blood Institute
Located in Columbus, Ohio, the Zangmeister Cancer Center offers comprehensive cancer and hematology treatments in three locations close to home. The clinic adheres to a holistic approach while providing outpatient treatment for cancer and blood disorders. Other services provided at the clinic include diagnostic imaging, offering most patients access to all of their cancer care under one roof.
Designed for easy access and patient comfort, the clinic also offers chemotherapy treatment and other infusions, targeted therapy and immunotherapy, laboratory services, a specialty pharmacy, care coordination including social services and access to cancer clinical trials. Zangmeister’s 11 highly skilled and compassionate physicians use the latest advancements in the diagnosis, treatment and prevention of cancer and blood disorders. Zangmeister Cancer Center prides itself on providing the most innovative cancer care available while meeting the physical, social, emotional and spiritual needs of patients. The clinic’s palliative team often serves as their patients’ advocate, helping them understand and manage the issues and problems that accompany the diagnosis and treatment of cancer.
11 Board-certified physicians
Eight advanced practitioners
Holistic approach
Diagnostic imaging
Palliative care team
The physicians at Zangmeister Cancer Center identified a number of future needs they considered priorities. Among them was finding a way to continue providing cost-effective care without sacrificing their autonomy.
“Zangmeister wanted to be able to continue providing good patient care in the community without having to send patients to an institutional setting, where the costs would be higher,” said Christine Pfaff, RPh, AON’s senior regional director of operations. Pfaff was Zangmeister’s associate practice director when the clinic entered into the partnership with the American Oncology Network (AON).
The clinic was also interested in adopting the value-based care (VBC) model and now-retired oncology care model and strengthening its revenue stream, especially through pharmacy services. Under the existing structure, lack of contracts with key payers meant Zangmeister was filling just about half of the prescriptions its clinical team was writing — and was still responsible for managing dosages and any side effects patients may experience from those medications.
“We were managing the patients, but those prescription revenues were going somewhere else,” said Pfaff.
Zangmeister Cancer Center ultimately partnered with AON in January of 2019. AON checked many boxes for Zangmeister, including setting the stage for implementation of the VBC model and now-retired OCM and strengthening its revenue stream. Most importantly, partnering with AON would still allow the clinic’s physicians to practice independently, making care decisions based on what was in the best interest of their patients.
“Small groups can sometimes have concerns about losing autonomy and independence if they join a corporate program,” said Jeanna Knoble, MD, a medical oncologist with Zangmeister. “With AON, we haven’t lost our autonomy and are free to practice what we consider to be the best medicine for our patients.”
The effects of the partnership were immediate. Zangmeister was able to provide patients with access to financial assistance counselors and charitable foundations, like the American Oncology Cares Foundation, to help pay for treatments and essential non-medical expenses. Other resources, such as access to the care coordination team and the clinic’s CPAN chapter for patient advocacy, were also available for the first time.
With AON, we haven’t lost our autonomy and are free to practice what we consider to be the best medicine for our patients.”
Jeanna
Knoble, MD
Zangmeister
Cancer Center
Working with AON’s pharmacy and leveraging the network’s ability to negotiate with larger payers helped increase Zangmeister’s fill rate to between 75% and 80%. In addition to making patients’ lives a bit easier, the higher volume added to the clinic’s bottom line and also allowed it to purchase medications at lower prices and with better payment terms.
“Before AON, all pharmacy revenue was walking out the door and causing a lot of headaches for us on the clinical side,” Pfaff said. “So that’s been a huge, huge help for us.”
Partnering with AON also gave Zangmeister access to a more robust revenue cycle department, leading to increased revenue by reducing claim denials and expediting the revenue cycle.
Partnering with AON allowed Zangmeister to keep treating patients throughout the COVID-19 pandemic. In addition to ensuring the clinic’s physicians and employees had enough personal protection equipment (PPE) and cleaning supplies, AON was able to have telehealth up and running inside the clinic in just one weekend — making Zangmeister the city’s first oncology practice to use the service regularly during the pandemic.
“As an administrator, I didn’t have to investigate programs or go through contracting with a vendor. AON did all that for us,” said Pfaff.
AON’s billing department also worked with Zangmeister on appropriate reimbursement for telehealth visits while the IT and operations teams educated the clinical staff on how to use the equipment and the scheduling staff on setting and cancelling appointments. As a result, Zangmeister was able to cut its in-person office visits in half by
performing more than 2,200 appointments via telehealth, helping prevent the spread of COVID-19 to patients and staff while allowing physicians to continue administering care.
“We were able to determine which patients needed to come into the clinic and which didn’t. For instance, patients receiving chemotherapy or someone having side effects or in need of lab work could come in, while those who had follow-up appointments or just had questions could be seen via telehealth,” said Pfaff. “We couldn’t have done any of that as timely as we did without AON.”
Because it was able to operate throughout the pandemic, Zangmeister maintained its patient volume and did not have to furlough or reduce staff. This, in turn, helped the clinic continue to provide top-quality care to its patients.
“While visiting a big hospital system, we were told that we were way ahead of the curve on this,” said Dr. Knoble. “It was really as smooth of a transition as possible in getting patients seen and cared for. That was a huge thing.”
Partnering with AON allowed Zangmeister to stay open and ahead of the curve throughout the COVID-19 Pandemic
Telehealth More than 2,200 virtual appointments
Supplies Enough PPE & cleaning equipment
Operations Training on proper procedures
Staff Retention No reduction or furlough of employees
Zangmeister leveraged its partnership with AON to expand its presence in the Columbus area to include clinics in Grove City and Westerville. By reaching out to patients who don’t have an oncologist nearby, Zangmeister is reinforcing what makes community oncology so special: Providing people with high quality care right in their own backyard.
Zangmeister’s physicians and employees have been so pleased with the AON partnership that they would like to get other practices on board who are struggling but concerned about maintaining their independence.
“We’ve seen a great benefit for our group, and we’d like to get other practices on board,” said Pfaff.
Join our network of physicians and advanced practitioners who are shaping the future of medical information.
We’ve seen a great benefit for our group, and we’d like to get other practices on board.
Christine Pfaff, RPh Zangmeister Cancer Center
Additionally, the clinic has become a strategic research site for Sarah Cannon Research Institute, launched its CPAN chapter for patient advocacy and now offers patients access to the American Oncology Cares Foundation for essential nonmedical expenses.
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VICE PRESIDENT OF RADIATION AND RADIOLOGY SERVICES
1. How long have you been with AON?
3½ years.
2. What does a “day in the life” look like for you in your role?
As general manager of AON’s Radiology and Radiation Services (R&R), much of my role has transitioned in the last three years from day-today operational oversight of existing radiology locations to the development and expansion of services for both existing and newly onboarded practices. As AON continues to grow, the development side of my role has evolved into a larger component of my day-to-day activities. Tasks like forecasting, financial analysis, project management, physician relationships, revenue cycle support, payer contract review and the new services development now fill up more of my time. Fortunately, we have established an excellent team of local radiology and radiation managers who effectively manage the day-to-day operations of their particular facility. I feel very fortunate to have such a talented team of managers and couldn’t be prouder of their performance.
3. What goals are you and your team working to achieve?
We just completed an extensive review of our radiology standard operating procedures (SOPs) with input from all AON’s radiology managers. As a result, revised radiology SOPs have been uploaded into our internal system, and widespread consensus has been reached from all AON’s radiology facilities. We will look to do the same for radiation over the next 12 months as we grow our technical staff and human capital in that segment. We also recently achieved approval for Radioligand Treatments (RLTs) at our final radiology location in Georgia. With this approval, all our radiology locations have added
RLTs to their Radioactive Materials License to bring this important treatment for prostate and neuroendocrine tumors to their region. This also sets the stage for future approvals of new RLTs currently under development for such indications as breast, lung and colorectal cancers and lymphoma.
4. How does your role contribute to AON’s overall mission and goals?
AON’s primary mission has always been to support the needs of community oncology practices so that they can continue to provide lifesaving cancer care to their patients where they live and in the most efficient and cost-effective ways. AON’s radiology and radiation services support this mission by directly bringing important diagnostic and treatment technologies to where this care is provided. In addition, we can provide these services more efficiently and at a lower cost than hospitals can — sometimes at half the cost. We also have the added benefit of providing these services in-house, thereby reducing one more stress our patients have to endure in navigating larger institutions while improving access to schedules and results for our physicians. My role is to expand these services to all practices, where it makes reasonable financial sense, and continually improve the efficacy and efficiency of our existing R&R operations.
5. What are you most proud of when it comes to your team and department?
While we have achieved so many milestones in the nearly four years of my tenure, I am particularly proud of the work we’ve done surrounding radioligands. I’m grateful to AON’s physicians and executive leadership for recognizing its value and allowing AON to be an early adopter of this technology. RLTs involve tagging therapeutic
radioisotopes to ligands or molecules designed to target specific cancers. The ligand drags the isotope to the cancer and then the isotope administers therapeutic levels of radiation directly to the area of interest. One example is a currently approved RLT from Novartis called Pluvicto which binds Lu-177 (a beta-emitting isotope) to a PSMA (prostate-specific membrane antigen) targeting ligand effectively creating a cruise missile that goes directly to prostate cancer. It was approved for recurrent late-stage metastatic prostate cancer's post-androgen deprivation therapy and taxane chemotherapy. However, Novartis has already submitted to the FDA to expand its use in pre-taxane situations based on positive clinical trial data. I would hope to see an expanded indication in the notso-distant future. This RLT concept has been the goal of nuclear medicine for 40 years, but the technology to bind the necessary ligand and isotope is only now coming into its own. I’m excited to see where this technology will lead as there are 30-plus companies with RLTs in various stages of clinical trials. I believe we will see an explosion of treatment options over the next three to seven years with some new ones likely to receive FDA approval as early as 2025.
6. What principles guide your work and vision?
Always strive for more knowledge and be cognizant of your approach toward your role and its responsibilities. In other words, allow your day-to-day actions to be driven by one major principle: make decisions as if the business were your own. I spent 20 years making those decisions for myself and my business, and when I joined AON, I found it difficult to turn that decision-making process off. What I discovered was that by applying those same principles in my role at AON, I seldom made a decision that I regretted. By implementing an “ownership” attitude to my everyday decisions, I typically choose a lower-cost option when purchasing supplies. I recommend projects to the executive team with higher margins or could at least justify proceeding ahead with lower-margin deals. I think twice before approving expensive purchases and consider how this purchase will advance our goals. I also ask important questions. Do we really need to hire that additional staff member, or is the recent increase in business activity transitory in nature? Finally, I try to instill these same principles in the managers who report to me as they make many decisions daily that I’m never involved in. Developing an entrepreneurial spirit in our managers not only benefits AON but sets up the individual for success in their future endeavors.
7. How do you define the word success?
Is the organization better off with me on the team than before I joined? Have I imparted my skills and experience to make the organization more successful in its mission? Finally, have I helped establish a platform for continued success even after I’m no longer part of the organization?
8. How do you lead your team? What is your leadership style?
I’ve worked hard over the years to move away from the general micromanager in me and instead, develop managers with strong supervisory skills. I try to encourage the R&R management team to view their actions and decisions through a looking glass that measures whether each choice is the right thing to do and serves the organization’s interest. I also strive to seek input from my reports on most major decisions and, where possible, consensus. This, typically, leads to more widely accepted outcomes. In the end, however, I’m tasked with making many difficult decisions within the scope of my responsibility, even if those decisions are unpopular. An effective leader needs to be prepared for those situations and willing to stand by their choice if they believe it's right for the organization. Leaders not only manage their operations, but they also keep vigil for situations that can harm the organization. If I fail to implement a service agreement for this expensive piece of equipment, I could save the company a lot of money. But what risk am I subjecting AON to? Will an unexpected repair cost more than the savings achieved by foregoing the service agreement? Can I go one more year with this PET/ CT scanner even though the manufacturer no longer makes parts for it? If I choose that path, how do I repair it in the event of mechanical failure? Does the potential patient volume justify purchasing an expensive imaging device? Are we inadvertently billing for procedures inappropriately, which may result in a large clawback from our payers down the road? These questions keep a good leader up at night, and I try to make the right choice in these situations in hopes of getting a good night’s sleep.
9. What’s your favorite part about working for AON?
I’m grateful for the opportunity to grow AON’s R&R business and the relatively long leash I’ve been given to do so. Since I’ve been with AON, we’ve gone from three radiology locations to six and added three radiation facilities. Over the next six months, we’ll add at least four more radiology locations. While this is very similar to what I’ve done in my previous business life, I am truly enjoying the widespread geography of this growth. Most of my experience was centralized in Georgia, and now I have the opportunity to participate in this expansion of services across the country.
10. What has been the most memorable moment for you while you’ve worked for AON?
While becoming more frequent, one of the first memorable moments for me at AON was seeing the PET/CT department open at Messino Cancer Centers in Asheville, North Carolina. This was the first AON PET/CT center I was involved in from the ground up. We didn’t acquire it as a pre-existing facility or as part of a practice acquisition. In fact, Messino had to pursue a Certificate of Need (CON) from the state to gain approval to install the PET/CT. This is a lengthy legal process that I had experience with, and I was able to provide some insight into Messino’s CON application. I’m pleased to say that Messino is now one of the busiest PET/CT facilities in the AON portfolio.
11. What motivates you to get up and get to work in the morning?
Accomplishing something meaningful. Whether implementing a new diagnostic imaging scan or radiation treatment, growing a segment of the business or expanding operations into a new territory, there is nothing more satisfying than looking back and thinking that there was nothing here before I started and now something meaningful has been established. Patients now have access to care and treatments that were previously unavailable, and new practices are enjoying the benefits that AON has to bring.
12. What is a quote you live and/or work by?
“Therefore, do not worry about tomorrow, for tomorrow will worry about itself. Each day has enough trouble of its own.” – Matthew 6:34
13. What are your favorite hobbies outside of work?
While not necessarily my favorite hobby, it seems that home improvement projects have become my wife’s favorite hobby for me, and I hate HGTV.
14. What is your favorite book (or books)?
Anything by Dean Koontz.
15. What is a fun fact about you?
My grandfather shot the sheriff, but he did not shoot the deputy. Ask me sometime and I may tell you the story.
16. What piece of advice would you give your younger self?
See answer to #12.
17. List three adjectives that describe your personality.
Opinionated, stubborn, compulsive. But I work hard to soften the edges on all of these and convert them to more positive traits.
18. What is one of your favorite travel destinations, or where do you hope to travel to in your lifetime?
Western Europe.
19. Who is your hero?
I don’t have one particular hero, but I’ve always had great admiration for people like Elon Musk who manage to accomplish more by themselves than with ten other people.
20. If you had three wishes, what would they be?
That my three children live a better and more fulfilling life than I did. I think all parents want that for their children.
As the number of individuals who are diagnosed with cancer increases, the funds available to financially support them decreases. American Oncology Cares provides financial support to assist qualified adult cancer patients undergoing treatment with non-medical expenses.
By alleviating some of the financial burden associated with essential living expenses like rent or mortgage, utilities, transportation, and food, patients can focus more on healing and getting better rather than finances and bills.
Search Program Overview
• Program launched October 2023.
• AON contracted with nonprofit America’s Charities to administer and manage American Oncology Cares.
• America’s Charities responsible for patient application review and distribution of patient grants.
• Monies raised in your state, benefit patients in your state.
• Active cancer treatment.
• Over 18 years old.
• Household income at or below 200% of the U.S. Federal Poverty Guidelines.
• Complete online application.
• Housing expenses, utility bills (gas, water and electric), and transportation and food costs associated with travel for cancer treatments.
• Qualified patients can receive a grant of up to $1,500 twice per calendar year.
• Please contact Kembly.Mourelo@AONcology.com
PHYSICIAN LIAISON
embly has been a physician liaison for the two clinics in the Grand Canyon State for three years. Before that, she was a radiation therapist and the executive director of the Alliance Cancer Support Center, the inspiration for the American Oncology Cares Foundation.
“Working in oncology is incredibly rewarding, especially at AON for several reasons,” Kembly shared when asked why she decided to join AON.
“I chose AON because of its commitment to research, the opportunity to connect deeply with patients and the dynamic environment that fosters continuous learning and collaboration. AON gives us these opportunities; it combines a passion for science with a strong desire to make a positive impact on people’s lives.”
When asked what she enjoys most about her role, she shared that there are many reasons.
“Representing doctors in oncology is rewarding. Oncologists' dedication, compassion and commitment to advancing cancer treatment are inspiring. Their ability to provide support and hope to patients is invaluable. Secondly, the
collaborative efforts within multidisciplinary teams and the continuous pursuit of knowledge make oncology a dynamic specialty. Working with cancer patients offers the opportunity to provide emotional support, education and a sense of hope, which can be deeply fulfilling. Lastly, as a radiation therapist, I've realized that patients often need more than just medical treatment. By establishing a support group, I've been able to address their needs and provide essential support. Transitioning to my role as a physician liaison, I'm committed to continuing this important work and supporting the community. It's fulfilling to be part of a team that prioritizes both treatment and overall well-being.”
Outside of work, Kembly is a passionate advocate for others, especially those battling cancer. Her dedication to running marathons is a testament to her commitment to helping others. As a sixcontinent marathon runner medalist, Kembly is currently training for her next challenge to become a seven-continent marathon medalist: the Antarctica marathon in early 2025.
CLINICAL NURSE MANAGER
arina has been with Cancer & Blood Specialists of Arizona, an AON practice in Case Grande, for more than five years. She is the clinical nurse manager and continues to work as an infusion nurse, a position she has held since joining the practice.
“I chose to work at AON and the clinic because I wanted to help provide cancer care in our community,” she shared when asked why she sought out a nursing position with AON. “I love working with our providers and staff to ensure our community is well served, as we are the only comprehensive cancer center in our county. Our patients are one of a kind and entrust us with their care.”
Karina's commitment to patient care isn't confined to the clinic; it's a constant, even in the most unexpected places. As she boarded a flight home from AON's annual operations meeting earlier this year, she never imagined her nursing skills would be put to the test to ensure another passenger’s safe travels home.
“Shortly after takeoff, one of the flight attendants came on over the intercom and asked if there was a doctor or nurse on board because a passenger was having an emergency. I was the only one on board,” she explained. “I assessed the patient and continued to ensure he was stable throughout the flight. We were able to get him to EMS when we landed, but not before being diverted from our original flight destination of Phoenix due to a dust storm. Thankfully for the passenger, we were diverted to Ontario, California, where the passenger was only a short distance from his final destination that night. I guess I call it divine intervention.”
If it was not for Karina’s swift intervention and immediate assistance to monitor the patient’s health and safety, the passenger’s health could have taken a dangerous turn.
When she is not caring for patients — on land and in the sky — she loves spending time with her family and enjoys activities like camping, watching sports, being outdoors and trap/skeet shooting.
Casey Brown, MS, RD, LDN
Oncology Dietitian
Today, there is significant debate about whether dairy is necessary in our diet. While consuming cow’s milk and other milk-based products has unquestionable benefits, some question whether the positives outweigh the negatives.
The American Institute for Cancer Research (AICR) and the American Cancer Society (ACS) encourage a healthy, plant-rich diet to reduce the risk of cancer and other chronic diseases. Plant foods include fruits, vegetables, whole grains and beans. These foods are a good source of fiber and other nutrients.
Beans, peas, and lentils (also referred to as pulses) are plant foods that are often underutilized. They are versatile foods that can be added to a variety of meals for extra flavor, fiber and protein.
Benefits of Beans, Peas, and Lentils
Beans, peas and lentils are nutrient-dense foods that are a great source of plant-based protein, fiber, iron, folate and potassium. A half-cup serving of cooked beans provides
about 7 grams of protein, which is similar to a 1-ounce serving of meat or poultry, and 4 to 10 grams of fiber.
Eating a diet rich in fiber may help with bowel regularity, lowering blood sugar and cholesterol levels, and weight management. A high-fiber diet is also associated with a lower risk for cancer.
Women should aim for 25 grams of fiber per day, and men should aim for 38 grams of fiber per day. These foods are also inexpensive and low in sodium, fat and cholesterol.
Beans, peas and lentils can be purchased dried, canned or frozen. These options have similar nutritional value, although canned beans tend to be higher in sodium. When purchasing these products, look for “no salt added” or “low sodium” options. Canned and frozen options are more convenient since they do not require as much cooking time.
Dried beans take longer to prepare since you will need to rinse, soak and cook them
There are many different types of beans, peas and lentils. Try experimenting with a variety of these since they have unique flavors and can be used in different recipes. Some of the common types include:
• Adzuki beans: Slightly sweet flavor, and great for salads, soups and casseroles.
• Black beans: Slightly sweet flavor, and great for soups, chili and rice dishes.
• Black-eyed peas: Earthy taste, and great for salads or rice dishes.
• Cannellini beans: Mild flavor, and great for casseroles, dips and Italian dishes.
• Chickpeas (or garbanzo beans): Nutty taste, and great for soups, stews and hummus.
• Kidney beans: “Meaty” taste, and great for chili, stews and bean salads.
• Lentils: Earthy taste, and great for soups and curry dishes.
• Navy beans: Mild flavor, and great for soups and Boston baked beans.
• Pinto beans: Earthy flavor, and great for stews, rice dishes and refried beans.
• Soybeans (or edamame): Full flavored, and great as a side dish.
first. You can soak the beans overnight by placing them in a container and covering them with water.
For a quicker method, you can place the beans in a large pot covered with water and bring them to a boil. You will then remove them from the heat, cover them, and let the beans sit for an hour. Before cooking the beans, it is best to drain the water and replace it with fresh water for cooking.
Breakfast:
• Avocado and hummus toast (add tomatoes, feta, red onion and other toppings)
• Breakfast burrito with pinto beans, rice, salsa and veggies
• Scrambled eggs with black beans and vegetables
• Sweet potato breakfast hash with black beans
• White beans and spinach omelet
Lunch and Dinner:
• Bean burritos (using black beans, pinto beans or refried beans)
• Chickpea salad sandwich on whole wheat bread or crackers
• Chili or curry dishes
• Falafel wrap with hummus, tahini dressing and mixed vegetables
When cooking, beans will need to be brought to a boil and then reduced to a simmer. Cooking times will vary from 45 minutes to 120 minutes depending on the type of beans.
These plant-based foods are versatile and can be added to a variety of recipes for any meal. Here are some ways to add plant-based protein to your meals.
• Grilled chicken salad with crispy beans (instead of croutons)
• Hummus quesadillas with sauteed vegetables
• Lentil-stuffed bell peppers
• Orzo and white bean salad
• Pasta with lentil meatballs
• Quesadillas (black beans or white beans with spinach)
• Soups: Black beans, lentils, minestrone (with kidney beans, white beans or chickpeas), navy beans, split peas, etc.
• Tacos with refried beans or black beans
• White bean pasta with pesto
• White bean sandwich with pesto and arugula
Snacks:
• Black bean protein energy balls
• Black bean salsa with chips
• Crispy roasted lentils
• Parmesan and garlic roasted edamame
• Raw vegetables or pita bread with hummus or a white bean dip
• Roasted chickpeas (add salt, parmesan, cinnamon or other flavors)
• Roasted kidney beans and chickpeas trail mix
Desserts and Smoothies:
• Black bean brownies
• Black bean chocolate mousse
• Strawberry or chocolate white bean smoothie
• White bean blondies
PREP TIME: 5 MINUTES // COOK TIME: 15 MINUTES // TOTAL TIME: 20 MINUTES // SERVINGS: 4
INGREDIENTS
1 tablespoon olive oil
1 large shallot, chopped
4 cups spinach, roughly chopped
5 cloves garlic, minced
2 (15-ounce) cans cannellini beans, drained
1 cup vegetable broth, more if desired
Kosher salt and black pepper, to taste
1/4 teaspoon crushed red pepper flakes
1/4 cup Parmesan cheese or nutritional yeast
1 to 2 tablespoons fresh lemon juice
1. In a large skillet, heat the olive oil over medium-high heat. Add the shallot and cook for 3 minutes, stirring occasionally.
2. Add the spinach and cook until wilted. Stir in the garlic and cook for 1 minute.
3. Stir in the beans and vegetable broth. Season with salt, pepper and crushed red pepper flakes.
4. Bring to a boil and then reduce to a simmer. Let simmer for about 10 minutes, stirring occasionally. The beans will get creamy and thicken. If you want to break up some of the beans with a wooden spoon, you can.
5. Stir in the Parmesan cheese (or nutritional yeast) and lemon juice. If the mixture is too thick for your liking, you can add a little extra vegetable broth.
6. Serve warm with bread, pasta, rice, eggs, polenta or potatoes.
NUTRITIONAL INFORMATION:
Calories: 319; Total Carbohydrates: 50g; Dietary Fiber: 11g; Total Sugars: 2g; Protein: 19g; Total Fat: 6g; Saturated Fat: 2g; Sodium: 373mg.
For complete recipe and nutrition facts: Two Peas & Their Pod
This past year, we've prioritized the health, happiness, and well-being of every team member. This milestone reflects our commitment to fostering a supportive and nurturing work environment where everyone can thrive.
Visit AON’s WellBeing program summary on SharePoint to learn more.
My name is Chris. I’m a throat cancer survivor, and this is my story.
My cancer journey began in the summer of 2023 when I was 48 years old. To give you some background, I served 20 years in the United States Army and retired in 2013. Following that, I was a contractor in Afghanistan, helping train their troops in Counter Improvised Explosive Device (IED) defeat.
Upon my return to the States, I obtained my bachelor’s and master’s degrees and spent several years at the University of North Georgia (UNG) in Dahlonega, working with their Corps of Cadets. Now, I’m living the dream and working with fellow Rangers at Camp Frank D. Merrill in Dahlonega as their military mountaineering training specialist.
All this to say, I’ve been lucky enough to train with some of the toughest people in the world. Some of my military experiences were difficult. And yet, nothing I’ve experienced measured up to some of what I endured during my cancer journey.
However, my past training very likely helped me keep a positive outlook and “let’s do this” attitude throughout my treatment. That was one of the most important factors for my success.
Staying positive is not easy, but it is possible and necessary.
On July 18, 2023, I noticed a small lump under the right side of my jaw. I wasn’t concerned. I just thought it was weird, so I mentioned it to my wife Jennifer. We decided then that it would be best to have it checked.
That next week I saw my primary care physician who identified it as an enlarged lymph node and ran a variety of blood tests — all of which came back within normal ranges. With no worries, my doctor sent me to a surgeon with a plan for removing it.
We were not very concerned at this stage because of the test results and thought everything would be easily handled with surgery. Thankfully, at the consultation appointment, my surgeon decided to perform a needle biopsy as a precaution.
That Labor Day, the surgeon called with the biopsy results, informing me that I had cancer. At first, I was speechless. Hearing that you have cancer is a huge shock and takes some time to process.
My wife and I did what I imagine most people do; we looked to Google to find answers. My advice to anyone who
may be on a similar path is to STAY OFF THE INTERNET. It scared us senselessly, and most of what we found did not apply to our situation, but we didn’t know that then.
If you are reading this and going through what is already a frightening ordeal, please do yourself a favor and let your healthcare professionals tell you about your specific cancer and treatment options.
It will save you from losing sleep needlessly. Once you have more information, you can then do your own research so that you can make informed decisions and come prepared with questions.
The next steps were taken very quickly by my doctor and surgeon. They referred me to an ENT (ears, nose and throat specialist) and medical oncologist who specializes in various tumor types and cancer treatments like chemotherapy.
This is when my wife and I met Dr. Aneesha Ananthula and Dr. Sreekanth Reddy from the community oncology practice Cancer and Blood Specialists of Georgia, who were recommended to us by my doctor and have truly made all the difference in this journey.
It was after a PET/CT scan that I learned more about my cancer. Dr. Ananthula shared that several lymph nodes, on both sides of my neck, were affected and that I had stage II throat cancer, which is a category of head and neck cancer. Fortunately, my prognosis was very good since we caught it so early.
Dr. Ananthula shared that "Chris was diagnosed with squamous cell carcinoma (SCC) of the oropharynx (or tonsil) and approached his cancer
diagnosis with remarkable resilience and determination. He expressed a strong will to fight the disease and found new perspectives on life. Throughout his journey, he focused on making the most of every moment, which inspired a deeper appreciation for his relationships, a renewed sense of purpose, and a commitment to personal growth and self-care. His positive attitude and inner strength became a beacon of hope — both for himself and his wife.”
Because of my diagnosis, I was not a candidate for surgery. Instead, I would need seven weeks of treatment with chemotherapy once per week and radiation five times a week.
This is when the difficult conversations started.
Dr. Ananthula explained how my body would likely react to chemotherapy and radiation. Beyond struggling with nausea, I was advised to expect throat pain, swelling, burning and extreme difficulty swallowing.
You see, the chemotherapy drugs alone can make you feel unwell with unpleasant side effects, and over time, the radiation can make it hard to even swallow water much less food.
She expressed the importance of remaining nourished and advised me to consider a feeding tube placement before beginning treatment.
For me, hearing that I may need a feeding tube was a bigger shock than hearing I had cancer. After talking to a couple of people who had been through similar treatments, I learned that a feeding tube may very well be necessary. I elected to have it placed before starting treatment.
This was a very good decision because getting a feeding tube is beyond
Dr. Ananthula shared that several lymph nodes, on both sides of my neck, were affected and that I had stage II throat cancer, which is a category of head and neck cancer. Fortunately, my prognosis was very good since we caught it so early.
nourishment or fluids that weekend and, by Monday, I was in bad shape.
This was my first lesson on how quickly things decline without nourishment. Thankfully, my chemotherapy treatment was on Monday, and Dr. Ananthula and her team took quick action, providing me with fluids, antinausea meds and a medication schedule to manage the pain and stomach upset.
through my feeding tube rather than the formulas I had been trying.
I tolerated blended food much better than any of the bottled or boxed formulas that always made me so nauseous. My wife even found recipes for blended tube feeding online. She used a heavy-duty blender to make the mixture smooth enough for tube feeding.
painful and adjusting to it takes some time. I could not imagine going through that process while also receiving treatment.
Dr. Ananthula also recommended that I get a port to make chemotherapy treatment easier on my body. That was another great decision.
The first two weeks of treatment were not that bad. My doctors warned me that symptoms may get progressively worse as time progresses and to expect it to become very difficult between weeks three and four.
Unfortunately for me, I had a couple of bad days between weeks two and three. I remember that on a Saturday, my throat started to hurt to the point that I could not swallow, and the nausea was so extreme that any movement made me incredibly sick. Even the thought of food was repelling.
Using the feeding tube also made me very nauseous. I wasn’t getting enough
At the time, I was devastated to have to postpone that week’s chemotherapy, but now I see that it made no difference whatsoever in my overall treatment. Just two days later I felt much better and received that week’s chemotherapy dose.
Following the new medication schedule put me back on track. I was able to begin eating and drinking through my mouth again. I’m someone who prefers not to take medication. When presented with a health concern, I default to nonchemical means for correction.
However, that simply was not possible for me during this treatment plan. If you are someone who also doesn’t like to take medications, please give it some consideration as a special circumstance during your cancer journey.
It may make all the difference. It kept me out of the hospital more than once.
I did well for the next couple of weeks. There were good days and some not-sogood days.
The last week of throat cancer treatment was incredibly difficult. For me, things improved slightly when I began consuming blended food
Once we began using those recipes, the weight loss leveled off, which was a relief. At one point, I lost between eight and 10 pounds in one week. During the last seven to 10 days of treatment, I was mostly dependent on tube feeding.
While the last couple of weeks of chemotherapy and radiation were difficult, they were nothing compared to the pain and suffering during the two weeks following the end of my treatment. I have never felt so much pain or been so sick in my life.
Having help during this time made all the difference. There were days when I could barely get out of bed or feed myself through the tube.
Please ensure that your support system remains in place even after treatment ends. You will need it.
After those first couple of weeks following treatment, I slowly began to recover. Be patient because this is a gradual process.
The more time that went by, the more energy I had. I kept trying to eat and drink so that I would know when it would be possible again.
I tried every day, even when it was painful or made me nauseous. I didn’t force it but was consistent with the effort.
Several months later, following my cancer-free diagnosis, I had my feeding tube and port removed.
That was the best day in a long time! I immediately felt better — like myself again. Things started to get better after that.
Now, about a year after my journey began, I’m doing and feeling great. I still weigh 150 pounds whereas I began this journey at 192 pounds and am focused on weight training and endurance building.
Recovering takes time and patience. I often must remember to be kind to myself and stay focused on the positives.
Here are four pieces of advice I would like to share with others who are facing a cancer diagnosis:
• Don’t rely on the internet for medical advice or information.
• Find a lump? Do not wait to get it checked out.
• Take your antinausea and pain meds. They make a huge difference.
• Lastly, never quit!
Dr. Ananthula continued to say, “Chris and his wife are an exceptionally wonderful couple, whose unwavering support for each other throughout this challenging journey is truly inspiring. They faced every hurdle together, with a positivity that was both uplifting and contagious. Their bond was evident as they attended every chemo appointment side by side, offering each other encouragement and strength. The love and unity they displayed in the face of adversity are worthy of admiration, demonstrating a partnership built on deep mutual respect and unwavering commitment.”
AON celebrates the power of patient stories, and your patients have stories of strength and hope.
Featuring your patients showcases the positive impact your practice and physicians make, strengthens your reputation as a leader in compassionate cancer care in the community and provides a source of inspiration and courage for other patients.
We are always seeking stories! Email Marketing@AONcology.com to learn more about how to request a patient story.
Closing the cancer care gap with transformational achievements.
At AON, we’re making great strides toward closing the cancer care gap by ensuring every patient has access to the care needed to help fight their cancer.
With an expanding network of more than 250 providers across 21 states, our practices are not only in big cities, they’re in rural areas where medical resources are scarce. Our clinicians are interconnected across state borders and focused on driving change by remaining at the forefront of new discoveries. Together, we’re doing more.
To drive equity forward, we aim to deliver precision medicine as a standard of care, adopt next-generation sequencing and provide structure to genomic data and more.
At AON, you’re part of a fast-growing network that’s setting great things in motion, exploring new horizons and breaking barriers to cancer care — where the future of cancer care is bright. Visit AONcology.com to learn more.
