Health Equity Report Card (HERC) Community Site Interest

NCCN will collaborate with five community oncology practices to pilot the implementation of the HERC over approximately 18-months. We are seeking a diverse group of community oncology practices to ensure the tool is tested in a variety of settings.

Goal: Evaluate the performance of the HERC in identifying and measuring health care practices with the potential to advance equitable care within health care organizations.

Primary Objective: To evaluate the feasibility of implementing the HERC with scoring at community oncology practices.

Site Expectations: Sites will participate in the 18-month project period. Sites will complete a self-score at baseline and 15-months utilizing a secure REDCap database, and NCCN will provide third-party score reports. Based on scores, sites will develop strategies and action plans to address low-scoring areas. NCCN will regularly engage with the sites to solicit feedback through surveys and site visits, to continue to enhance the HERC, processes, and resources. Project support totaling $50,000 will be provided in five milestone payments to participating sites. Note that this project does not collect any protected health information.

Eligibility Criteria:

Community oncology practice, including but not limited to safety-net, rural, community affiliate of academic medical center, private practice settings, and/or other relevant community practice settings
Located within racially and ethnically diverse region, per current US Census data
Serve a geographically distinct patient population with limited overlap of catchment area to other participating sites
Have the personnel resources to support project activities
Agree to participate in study

If your practice meets the eligibility criteria and is interested in learning more about the HERC pilot project, please complete the following questions.

Question Title

1. Practice Name (Required.)

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2. Practice Address

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3. How would you describe your practice? Select all that apply. (Required.)

Independent physician practice

Community hospital

Affiliate of a health system

Affiliate of a community oncologist network

Other (please specify)

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4. Practice Size

Number of Providers

Total Number of staff

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5. Population Served: Race and Ethnicity (Estimated Percentage)

White

Black / African American

Asian

American Indian / Alaska Native

Native Hawaiian / Pacific Islander

Multi-racial

Other race

Unknown/Not Provided

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6. Population Served: Insurance Status (Estimated Percentage)

% of patients with Medicare as primary coverage

% of patients with Medicaid as primary coverage

% of patients with private insurance as primary coverage

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7. Contact Information (Required.)

Full Name

Title

Email Address

Phone Number

Health Equity Report Card (HERC) Community Site Interest

Question Title

* 1. Practice Name (Required.)

Question Title

* 2. Practice Address

Question Title

* 3. How would you describe your practice? Select all that apply. (Required.)

Question Title

* 4. Practice Size

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* 5. Population Served: Race and Ethnicity (Estimated Percentage)

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* 6. Population Served: Insurance Status (Estimated Percentage)

Question Title

* 7. Contact Information (Required.)

1. Practice Name (Required.)

2. Practice Address

3. How would you describe your practice? Select all that apply. (Required.)

4. Practice Size

5. Population Served: Race and Ethnicity (Estimated Percentage)

6. Population Served: Insurance Status (Estimated Percentage)

7. Contact Information (Required.)