National Oncology State Network: Making a Difference

Sheryl A. Riley, RN, OCN, CMCN
Managing Partner
Clarion, LLC
Bernardsville, NJ

How many times over the course of your career have you thought about joining a professional organization? With only so much time, energy, and resources to go around, it is important to be selective and choose associations that will meet your professional needs, work within your schedule, and add value to your professional life.

Last year, while attending an oncology conference, I ran into 2 colleagues whom I have respected throughout my career. During a conversation over dinner, they told me about the National Oncology State Network (NOSN). In all honesty, I was not familiar with this organization and knew that I needed to learn more about it before becoming a member.

Over the next few hours, as we discussed the mission and vision of NOSN, I began to realize the value that this organization provides to the oncology community. I found it intriguing that NOSN has had such a major impact on the quality of cancer care for patients in so many states—very few organizations can make such a bold claim. Most national organizations focus on creating policy or lobbying for guidelines from a single national perspective. As a result, their efforts may not directly improve care for patients at the state level. In contrast, NOSN functions at the state level to ensure that patients have access to what they need, when they need it.

Addressing the Need for Better Communication Among Leaders

For decades, oncology leaders from different states met (in an informal manner using the NOSN acronym) to discuss leadership and policy issues that they saw cropping up in 1 or more states. The founders of the current NOSN remembered the value of this type of communication among themselves and their peers and decided to create a formal organization where such communication could be accomplished more effectively and lead to demonstrable action.

The following scenario illustrates the importance of consistent and clear communication among professionals across state lines. Approximately 5 years ago, a major payer created a clinical pathways program in California, and it was rolled out in several states. Before the program reached Connecticut, the payer informed Dawn Holcombe, MBA, FACMPE, ACHE, who was Executive Director of the Connecticut Oncology Association at the time, that the oncology association leaders in southern California had endorsed this particular program. Ms Holcombe thought that sounded unlikely, so she immediately reached out to Mariana Lamb, who was Executive Director of the Medical Oncology Association of Southern California at the time, to discuss the situation further.

It became evident that some miscommunication—and perhaps a bit of misdirection—had occurred. If the leaders of all states had been talking on a more formal and frequent basis, they could have initiated earlier and consistent challenges to this national payer program. As it was, these clinical pathways were rolled out in many states before they could be addressed successfully and cohesively, which affected numerous physicians and patients.

An Effective Approach to Improving Cancer Care

NOSN is an action-focused, not-for-profit organization built and managed by oncology professionals who are leaders in their individual states, and who are motivated to volunteer their time to communicate across state lines for the benefit of patients with cancer. Its members identify areas of collaboration on emerging state issues to improve oncology care and policy across the country, catching trends and initiatives early before they reach multiple states. NOSN also serves as an incubator and a promoter of shared ideas and resources.

Each state has challenges that require complex solutions, and NOSN’s teams strive to identify professionals from different areas of oncology to respond to these challenges within their states. This comprehensive team strategy maximizes resources, which can improve patient care on a local as well as a national level. Although individual states have different populations and varied solutions to their problems, there may still be common problems that could be solved by sharing the wealth of knowledge in each of those states. NOSN is the first organization dedicated solely to harnessing this information sharing—communicating monthly to raise individual state issues to the national level for the greater good of patients with cancer.

Partnering with NOSN

Currently, NOSN partners represent 39 states and include a diverse group of physicians, oncology nurses, oncology state leaders, cancer center leaders, and industry representatives. NOSN fills a significant gap in healthcare policy and action by aggregating the valuable resources and skills found at local state levels, raising the level of communication and collaboration to a national level. The goal is that no partner will find themselves blindsided, or alone, in tackling individual issues that could quickly become universal challenges or opportunities across all states.

NOSN does not seek to replace individual state or national organizations but to provide a bridge—a key aggregation of initiative, value, and voices of the states nationally.

Each state partner is an integral part of the NOSN team. In addition, industry partners have a true seat at the NOSN roundtable; they are welcome at the organization’s activities instead of being relegated to financial sponsorship or the periphery of the meetings. Industry partners also have complete access to state partners, can attend the partner meetings on a quarterly basis, are invited to serve as active participants on NOSN teams, and can attend NOSN’s Annual Partners Meeting, where members meet face-to-face to create the agenda for the next 12 months. I find this to be one of the most unique aspects of NOSN.

Obtaining key industry information from partners and sharing with them what is happening state by state creates an exceptional bond and a trusting relationship where solutions become reality. NOSN members have a “Can do, let’s get it done” attitude that drives innovation and collaboration between states and industry.

Over the past 2 years, NOSN has successfully built and energized activities in several states for the development of cancer caucuses in the state legislatures, and has addressed diverse issues related to pharmacy standards applications to medical centers and private practices. These are complex issues, for which NOSN partners have worked to create a common platform of messaging, communication, development tools, talking points, and strategy. Individual states and NOSN partners do not have to reinvent the wheel but can apply the elements of this common platform as a catalyst for activities in their own states, with the readily available support of their NOSN partners.

NOSN’s key areas of focus directly affect the care that patients with cancer receive within their states and in their physicians’ offices. The crucial ingredients lie in the monitoring of state legislation, activities, and policy. The creation of initiatives to develop and ensure consistency across state lines address various areas, including:

  • Prior authorization
  • Certificate of need
  • Pharmacy Benefit Managers
  • Step therapy
  • Oral parity
  • Payer policies and initiatives
  • Copay accumulators
  • Ensuring reasonable interpretation of US Pharmacopeia Pharmacy Standards through monitoring and influencing state activities.

Most recently, the organization has added a diverse committee of state and industry partners to approach employer groups and business coalitions regarding access to quality cancer care for their employees.

NOSN is comprised of a team of like-minded, action-oriented, oncology professionals who have joined together to make a difference for every patient and share their success and knowledge with others to improve cancer care across state lines.

If you are interested in becoming a state or industry partner, please reach out to NOSN’s Administrator, Nichole East, at This email address is being protected from spambots. You need JavaScript enabled to view it..

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