NCCN Survey Reveals Oncology Community Professionals’ Concerns About Financial Distress, Access to Care

Key Points

  • More than 70% surveyed noted that patients have voiced concern about the anticipated repeal and replacement of the Patient Protection and Affordable Care Act (ACA).
  • Overall, 55% of respondents reported that the anticipated large-scale changes to federal health-care policy would likely have a negative impact on their practice, research programs, or patient outcomes; 11% anticipated a positive impact, and 34% anticipated a neutral or mixed impact.

Oncology community professionals are concerned about the ability of their patients to access cancer screening and treatment under the proposed American Health Care Act (AHCA), according to a survey conducted March 23–24, 2017, at the National Comprehensive Cancer Network® (NCCN®) 22nd Annual Conference: Improving the Quality, Effectiveness, and Efficiency of Cancer Care™ in Orlando, Florida.

In addition, a majority of those surveyed believed that anticipated health policy changes would have negative impacts on their practices and on cancer research. More than 70% surveyed noted that patients have voiced concern about the anticipated repeal and replacement of the Patient Protection and Affordable Care Act (ACA), nearly two-thirds of whom have demonstrated increased levels of distress.

The survey was conducted during the period of congressional debate over the AHCA, which was withdrawn the afternoon of March 24, when it became clear there were not enough votes to pass the legislation. Responding to the survey were 76 oncology professionals, including physicians (academic and community), nurses, physician assistants, pharmacists, industry professionals, payers, and patient advocates.

“The AHCA is tabled, and the ACA remains in place, but concerns about access to cancer screening, care, and research funding remain. Today, patients are in limbo, not knowing what action the federal and state governments will take,” said Robert W. Carlson, MD, Chief Executive Officer of NCCN. “NCCN agrees there are ways to improve the current health-care system for Americans with cancer, the clinical professionals who care for them, and payers. However, we are concerned for Americans with cancer that affordability, coverage of products and services in cancer treatment, and overall access will be impeded by allowing health insurers to set their own rates or by providing states the ability to experiment with Medicaid coverage without appropriate patient protections.”

The NCCN Trends™ survey found:

  • 55% of respondents reported that the anticipated large-scale changes to federal health-care policy would likely have a negative impact on their practice, research programs, or patient outcomes; 11% anticipated a positive impact, and 34% anticipated a neutral or mixed impact.
  • When asked to select from a list of outcomes they anticipated would occur with changes to health-care policy, those who anticipated a negative impact (55%) indicated:   

—Fewer patients will have access to health insurance (71%)

—High deductibles will limit patient access to care (69%)

            —Cancer screening rates will decline due to higher copays and deductibles (63%)

            —Patients’ preexisting conditions could be excluded from coverage (57%)

            —Federal funding for cancer research will decline (56%)

            —There will be less support for mental health services (50%)

  • Those who expected a positive impact (11%) indicated:

—With increased competition for insurers operating across state lines, health insurance premiums and copays will go down for more patients, leading to improved access to care (50%)

—Allowing medications to be imported will create more competition and reduced drug prices (50%)

—Patient health savings accounts will lead to increased price transparency for medical procedures and medications, causing health-care costs to drop (38%)

  • When asked, “What kind of impact do you believe changes in federal health-care policy will have on your patients’ ability to afford cancer care?” 66% of respondents said the impact would be negative, 9% said positive, and 25% said the impact would be neutral.
  • To the question, “To your knowledge, are your patients affected by health insurance policy and the possible repeal and replacement of the Affordable Care Act?” respondents answered:   

—Yes, patients have expressed concern and demonstrated greater levels of distress (50%)

—Yes, patients have expressed concern but no evidence of health impact (21%)

—No, I have not seen any effects (29%)

“President Trump included three key elements in his approach to health coverage reform: repairing necessary aspects of the ACA, ensuring greater access, and lowering the total cost of care,” Dr. Carlson said. “We are ready to share our Network’s expertise with lawmakers to deliver a value-based health policy to ensure that all Americans with cancer have access to high-quality, effective, and efficient cancer care.”

Below is a link to Dr. Carlson’s March 21, 2017 letter to Congress outlining NCCN’s concerns about the health policy proposal and patient access to care:

https://www.nccn.org/professionals/meetings/oncology_policy_program/pdf/2017_NCCN_AHCA_Letter_Walden_03-22-2017.pdf.

For more information about NCCN’s health-care policy initiatives, visit NCCN.org/policy.

The content in this post has not been reviewed by the American Society of Clinical Oncology, Inc. (ASCO®) and does not necessarily reflect the ideas and opinions of ASCO®.


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