Abstract
Health care as we know it is in trouble. Most people agree that reform is needed (new models of care and more cost-effective care), but who can answer the overwhelming number of questions that come to mind? And how will anyone ever agree? This past April, the Centers for Medicare & Medicaid Services (CMS), part of the Department of Health and Human Services, published a proposed regulation recommending the implementation of accountable care organizations (ACOs). The goal of this proposal is to place primary care providers (physicians) at the helm of coordinating patient care, utilizing evidence-based practice, and containing costs. Many in the oncology community are concerned because this proposal has completely neglected cancer care. In addition, the CMS proposal largely disregards the contributions of nurse pracitioners, clinical nurse specialists, and other advanced practitioners. This commentary addresses these and other issues of health-care reform relevant to the oncology advanced practitioner community.
