This  Notes from the Field  piece provides information on the work of MCC\u27s cancer control priorities and the results of collaborative efforts to address them. The MCC\u27s Clinical Trials Workgroup was tasked with developing a project to support the Cancer Plan for Michigan’s Diagnosis and Treatment Goal in 2016

Putt, MPH, CPH, Audra

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Michigan Journal of Public HealthVolume 9Issue 1 Special Issue: Michigan Cancer Consortium Article 92018Expressway to Cancer Clinical Trials: ReducingAdministrative Barriers to EnrollmentAudra Putt, MPH, CPHMichigan Department of Health and Human ServicesFollow this and additional works at: https://scholarworks.gvsu.edu/mjphPart of the Public Health CommonsThis Article is brought to you for free and open access by ScholarWorks@GVSU. It has been accepted for inclusion in Michigan Journal of PublicHealth by an authorized editor of ScholarWorks@GVSU. For more information, please contact scholarworks@gvsu.edu.Recommended CitationPutt, MPH, CPH, Audra (2018) "Expressway to Cancer Clinical Trials: Reducing Administrative Barriers to Enrollment," MichiganJournal of Public Health: Vol. 9 : Iss. 1 , Article 9.Available at: https://scholarworks.gvsu.edu/mjph/vol9/iss1/9Michigan Journal of Public Health 30 Volume 9, Issue 1 2018  NOTES FROM THE FIELD  Expressway to Cancer Clinical Trials: Reducing Administrative Barriers to Enrollment Audra Putt, MPH, CPH, Michigan Department of Health and Human Services For nearly 20 years, the Michigan Cancer Consortium (MCC) has been involved in efforts with a variety of stakeholders to increase cancer patient participation in clinical trials. In 2001, the MCC partnered with the Michigan Working Group to Improve Cancer Outcomes on the development of the Consensus Guidelines for Healthcare Coverage of Routine Patient Care Cost Associated with Oncology Clinical Trials. The goal of this Consensus Agreement’s creation was to increase participation in specific cancer-related clinical trials by supporting the predictability of payment for clinical trial services. The voluntary Consensus Agreement includes a framework detailing third party payer coverage of patient costs in relation to their benefit plan for clinical trial enrollment. Members of the Michigan Association of Health Plans supported the Consensus Agreement and agreed to increase participation in cancer-related clinical trials through coverage of routine costs associated with participation. A 2015 assessment supported by the MCC found clinical trial coverage through larger Michigan health plans (including Medicaid and Medicare) generally aligns with the Consensus Agreement.   With changes related to health care coverage through the Affordable Care Act and advancements in treatment, the MCC Board of Directors selected increasing cancer clinical trial enrollment as the 2016-2017 priority under the Cancer Plan for Michigan’s Diagnosis and Treatment Goal in 2016. The MCC Clinical Trials Priority Workgroup was tasked with developing a project to support this effort. The workgroup convened with the goal to ensure Michigan residents with cancer who want to join a clinical trial can do so with fewer barriers. In 2016, 7 percent of Michigan adults who reported a cancer diagnosis also reported participating in cancer treatment clinical trials (Michigan Department of Health and Human Services, 2016).   The workgroup began by surveying stakeholders with the MCC and Michigan Society of Hematology and Oncology (MSHO) to assess barriers to clinical trial enrollment. Survey results indicated that providers had concerns with the sometimes-lengthy clinical trial enrollment process. As a result, the workgroup decided their project would address prior authorization concerns. Insurers often require prior authorization for cancer clinical trial enrollment, and ask for different pieces of information. This can lead to communication barriers between providers and insurers. In some instances, patient enrollment can be delayed by weeks while prior authorization is approved. The workgroup project focused on facilitating more rapid response to prior authorization requests by creating a fax cover sheet that could be shared with practitioners and used as a “heads up” when enrolling patients in cancer clinical trials. The fax cover sheet was created for use when a health insurance carrier requires prior authorization for participation in a cancer clinical trial. It asks for such information as why the patient is eligible to participate, the therapeutic purpose for conducting the trial, and whether the trial is federally funded (see Appendix A for the fax cover sheet). Use of the fax cover sheet intends to simplify the prior authorization process and reduce the time needed to prepare and receive approval for authorization, thus decreasing the administrative burden for providers and insurers. The MCC Board of Directors approved the fax cover sheet in August 2016 and made it available as a fillable form on the MCC Website.   Michigan Journal of Public Health 31 Volume 9, Issue 1 2018   After development of the fax cover sheet, the workgroup established a promotion plan for sharing it with various stakeholders and partners. Steps were taken to promote the fax cover sheet at the MCC Annual Meeting, on the MCC Website, at hospital cancer committee meetings, and with partner newsletters. Following promotion, an evaluation plan for determining the cover sheet’s reach was also established. In 2017, it was downloaded from the MCC website 261 times. Questions about knowledge and use of the fax cover sheet were included in the 2017 MCC Annual Survey. MSHO members were also surveyed on similar questions in the fall of 2017. The results from both surveys (Figure 1) indicated there is still work to be done with promoting the fax cover sheet.   Michigan Cancer Consortium Member Survey Michigan Society of Hematology and Oncology Member Survey Number of respondents (N=) 86 111 Aware of the cover sheet 23 (26.7%) 21 (18.9%) Used the cover sheet in their office 3 (3.5%) 12 (10.9%) Figure 1. Partner Knowledge and Use of the Clinical Trials Fax Cover Sheet Form  Over the next two years, the workgroup will continue to promote cancer clinical trial enrollment. A new project will be undertaken by the workgroup to develop infographics for patients and primary care providers, detailing the benefits of clinical trial enrollment. To support health equity, the infographics will meet accessibility guidelines. The MCC and Clinical Trials Priority Workgroup will remain dedicated to providing support and resources to increase the number of Michigan adults with cancer who participate in cancer clinical trials.     This publication was supported by the Cooperative Agreement NU58DP006334 from the Centers for Disease Control and Prevention.  Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the Centers for Disease Control and Prevention.  Michigan Journal of Public Health 32 Volume 9, Issue 1 2018   References 1. Michigan Department of Health and Human Services. (2016) Michigan Behavioral Risk Factor Surveillance System.   Michigan Journal of Public Health 33 Volume 9, Issue 1 2018  Appendix A: MCC Clinical Trials Cover Sheet     

Expressway to Cancer Clinical Trials: Reducing Administrative Barriers to Enrollment

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Expressway to Cancer Clinical Trials: Reducing Administrative Barriers to Enrollment

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