We want to increase our membership to include everyone involved in oncology care, such as nurse practitioners and physician assistants, because they are critical to our future.
—James N. Frame, MD, FACP
Now in its fifth year, the West Virginia Oncology Society (WVOS) is already having a major impact on cancer care in the state. In 2010, a joint initiative to develop a statewide cancer clinical trials network was launched by WVOS and the West Virginia University Cancer Center. With funding support from ASCO’s State Affiliate Grant Program to help build the infrastructure for the West Virginia Cancer Clinical Trials Network, plans for the development of the network are nearing completion this year, with 15 academic institutions, community hospitals, and private practices joining the program so far.
The clinical trials network will enable residents of West Virginia to receive state-of-the-art oncology treatment in the communities where they live, rather than having to leave the state for the most advanced care, said James N. Frame, MD, FACP, Immediate Past President of WVOS, Chair-elect of ASCO’s State Affiliate Council, and a leader in organizing the development and implementation of the West Virginia Cancer Clinical Trials Network.
With 250 members, WVOS is active in addressing the issues confronting oncologists and patients in West Virginia, including oncology drug shortages and physician reimbursement by the Centers for Medicare & Medicaid Services (CMS), as well as participating in legislative efforts to ensure the comprehensive establishment of the state’s health insurance exchanges, which will go into effect in 2014 as part of the Patient Protection and Affordable Care Act.
The ASCO Post talked with Dr. Frame about WVOS’ accomplishments since its founding and its future goals.
Origins of the West Virginia Oncology Society
Why was it important for West Virginia to become an ASCO State Affiliate and have its own oncology society?
We wanted West Virginia to have a voice in matters that related to patient care, research, and legislative advocacy. The reason we established a new society in 2008 is largely due to changes in the jurisdictions of Medicare Administrative Contractors. West Virginia used to be part of the Ohio/West Virginia Oncology Society, but with the changes in Medicare Administrative Contractor jurisdictions, West Virginia was assigned to the J11 region, which includes Virginia, North Carolina, and South Carolina. Thus, we were no longer part of Ohio’s jurisdiction, which meant that we would no longer have a society to represent our state.
The changes mandated by the Medicare Administrative Contractor realignment got us thinking about forming our own society, and oncologists from academia, community hospitals, and private practice developed an informal coalition. We especially wanted to develop a clinical trials network to better serve West Virginians.
There were only 18 medical sites in the state where cancer care is delivered, and maybe just 4 or 5 sites that offered clinical trials. We are a population of nearly 2 million, geographically separated by mountains and valleys. Before we formed the West Virginia Oncology Society, it was difficult for oncologists to meet each other and establish a collegiality that would enable us to form relationships and collaborate on patient care. So launching the West Virginia Cancer Clinical Trials Network provided a means to bring us together, and then we created our mission statement and articulated our vision for what we wanted to accomplish.
Strength of a Coalition
I read that more than 85% of West Virginia’s cancer specialists had already joined your society within its first year of existence.1 Why is WVOS so successful in attracting new members?
I think it’s our team spirit and the fact that we respect all oncology practice settings, from university and community hospitals to private practices. We’ve also aligned ourselves behind goals that are important for improved patient care, and we’ve delivered results.
For example—and this is the result of the efforts of former WVOS President John Azar, MD—when we were putting together our bylaws in 2008, the West Virginia Employees Insurance Agency, one of the state’s largest health-care payers, didn’t cover BRCA1 and BRACA2 gene testing for patients with breast cancer on Medicaid. Through Dr. Azar’s and WVOS’ advocacy efforts, we were able to get coverage for the test.
The strength of a coalition of physicians, nurses, pharmacists, and educational sponsors gave us the voice to lobby for coverage of the test, and it showed that we can get things done.
Our other great effort, of course, is the formation of the West Virginia Cancer Clinical Trials Network.
How are you able to confront the oncology drug shortage problem affecting your state?
The problem is much better now. But in 2011, agents like leucovorin, anthracyclines, and cytarabine were in short supply. We established a policy whereby if any practice in West Virginia was running into a drug shortage problem, we would post the information on our website and ask members for suggestions or remedies. It was a way for us to help each other in a transparent way and ensure that our patients had the treatment they needed.
What challenges do you face that are unique to your society?
We are a small state with a big heart, and we want to make sure that our voices are heard and that problems can be solved to provide the best oncology care for our patients. That requires us to have a strong legislative advocacy effort. For example, under the leadership of WVOS President Arvind Shah, MD, we have taken a position on H.R. 1416, a bill introduced in Congress to exempt cancer drugs from the 2% Medicare sequester cut, and have asked our members to take action by contacting their Congressional representative about this issue.
The West Virginia Oncology Society has also submitted comments on the proposed rules for the establishment of the state’s health insurance exchanges under the Patient Protection and Affordable Care Act, and has asked for more direct guidance from the Department of Health and Human Services to ensure that patients with cancer have access to chemotherapies.
In addition, WVOS submitted comments on the 2013 Proposed Physician Fee Schedule to CMS. So as a society, we are starting to mature in our advocacy mission.
What are your future goals?
We want to increase our membership to include everyone involved in oncology care, such as nurse practitioners and physician assistants, because they are critical to our future. We want to bring them into the fold and provide them with educational opportunities.
Our other great challenge as a state society is helping bring down the high cancer mortality rate in West Virginia, which is the highest in the nation, due in large part to smoking, obesity, and having an older population. We are hoping that with the full implementation of the West Virginia Oncology Trials Network throughout the state, providers will have the training and infrastructure to offer clinical trials to more patients with cancer and provide improved access to cutting-edge therapies. ■
Disclosure: Dr. Frame reported no potential conflicts of interest.