Global Access Project
What is the Global Access Project?
In February 2004, the National Patient Advocate Foundation established the Global Access Project (GAP), a neutral research entity whose mission, past, present and future, is to complete independent research projects by nationally respected and recognized experts in specific fields of health care. The research projects are designed to provide specific information relative to reimbursement; access to quality healthcare; national trends in access to health care including clinical trials; changes in treatment sites of care; and research to define deficiencies in the current coding structure of reimbursement.
To date, seven studies have been completed and the findings presented to key officials in Administration, Centers for Medicare and Medicaid Services (CMS), Medicare Payment Advisory Commission (MedPAC), and Congressional Committees of jurisdiction on healthcare. From inception, National Patient Advocate Foundation assembled a GAP stakeholder group of 40 organizations.
Today, 42 organizations are part of the GAP stakeholder group. GAP studies have been frequently cited by national stakeholders including: US Oncology, International Oncology Network (ION), Oncology Nursing Society, Leukemia & Lymphoma Society, NPAF and members of industry. GAP studies have been consistently labeled as non-branded, neutral and unbiased.
Additionally, GAP studies are well received by the major decision makers in Washington D.C. including committees with jurisdiction over healthcare issues, CMS, MedPAC and the Administration. These stakeholder groups have requested that these studies continue.
Nurses' Perceptions of Oncology Practice in Outpatient Settings in 2008: Survey of Oncology Nursing Society Members
The Moran Company - September 2008
The objective of the study was to revisit a 2005 GAP sponsored survey of oncology nurses soliciting their observations about changes in oncology care with a focus on new policies implemented as a result of the Medicare Modernization Act (MMA) that reduced reimbursement for physician administered drugs while increasing reimbursement for drug administration in certain health care settings.
Chemotherapy After the Medicare Modernization Act: Have Changes in Reimbursement Policy Affected Access to Care?
Duke Center for Clinical and Genetic Economics - September 2007
The objective of this analysis was to determine whether Medicare beneficiaries access to care has been affected by changes in chemotherapy reimbursement methodology as mandated by the Medicare Modernization Act.
The Medicare Modernization Act and Changes in Reimbursement for Outpatient Chemotherapy: Do Patients Perceive Access to Care?
Duke Clinical Research Institute, Duke University Medical Center - September 2006
The two primary objectives of the study were to (1) measure and compare time to initiative of chemotherapy for patients undergoing treatment either before or after the enactment of the MMA; and (2) measure and compare the location of care for patients undergoing chemotherapy either before or after the enactment of the MMA. To meet these objectives, Medicare claims data was analyzed for 2002 through 2004 and a web-based survey of patients with cancer was conducted.
Baseline Study of Patient Accrual Onto Publicly Sponsored Clinical Trials: An Analysis Conducted for the Global Access Project of the National Patient Advocate Foundation
Coalition of Cancer Cooperative Groups (CCCG) - February 2006
The purpose of the study is to establish a baseline patient accrual onto publicly funded cancer clinical trials in the community and academic setting, and establish a statistical model to account for the number and type of trials available, to better assess whether enrollment to clinical trials is occurring as expected. The report represents data collected from the Clinical Data Updates System (CDUS) of the National Cancer Institute, through the baseline period from January 1, 2003 through June 30, 2005.
Changes in Oncology Practices in the First Quarter of 2005: Are Changes in Medicare Reimbursement For Drugs Implemented in 2005 Influencing Oncology Practice?
The Moran Company - September 2005
The primary purpose of this study was to examine changes implemented by the Centers for Medicare and Medicaid Services (CMS) contained in the Medicare Modernization Act (MMA) that reduced reimbursement for drugs and increased reimbursement for drug administration in physician offices and certain other health care settings. The study is based on a survey of the Oncology Nursing Society (ONS) and examines the experience of oncology practices across the country by surveying oncology nurses in both inpatient and outpatient settings.
Adult Cancer Clinical Trials in the Community Setting: A Baseline Study to Examine Patient Accrual
Aspen Systems Corporation - February 2005
The primary purpose of the study was to assess the distribution of a level of patient accruals to clinical trials of investigational cancer care in the community setting as compared to other settings, primarily academic centers. The results of this study will contribute to future research to ascertain and assess trends in access and accruals to trials in the community setting that could be attributed to changes to the Medicare program or other variables.
Documentation of Pharmacy Cost in the Preparation of Chemotherapy Infusions in Academic and Community-Based Oncology Practices
University of Utah - February 2005
The research project assists in the identification of "true cost" associated with the drug-related handling for the preparation and delivery of chemotherapy doses. The cost of purchasing the drugs and physically administering them to patients was not included. Analysis found that oncology pharmacists spend almost their entire day related to tasks associated with the preparation of chemotherapeutic agents. This validates the need for the consideration of these services for reimbursement and for the study.
Geographic Access to Care Study
Kathleen Dalton, Ph.D., University of North Carolina - Chapel Hill - January 2005
The purpose of the study is to gather baseline information on cancer patients' access to oncology services during the period immediately preceding the passage of the Medicare Modernization Act (MMA). The study's principal objective is to summarize the distribution of cancer patients and cancer care providers across regions and population types, paying special attention to potential differences in access to care that might be related to rural location, race, ethnicity or low-income status.
Practice Expense Reimbursement for Cancer Care Services: Methodology Evaluation & Assessment of Alternative Policies
The Moran Company - September 2004
The study analyzes the Centers for Medicare and Medicaid Services (CMS) methodology for setting payments for medical oncology services, specifically the "practice expense" component of Medicare payments for those services. Additionally, the study compares CMS practice expense payments to oncology practice costs as reported by the American Society for Clinical Oncology (ASCO) survey and discusses the reasons for any shortfalls. Finally, potential policy options for policymakers seeking to mitigate or eliminate any shortfalls are provided.
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