As more cost pressures are placed on the health-care system, and the transition to value-based care gains momentum, the Association of Community Cancer Centers’ (ACCC) 7th annual Trends in Cancer Programs survey revealed critical challenges and emerging trends in U.S. cancer programs. The cost of cancer drugs was named the top challenge by 2016 survey respondents (83%)—nearly double the number (45%) from last year’s survey.
ACCC member programs are meeting this challenge head-on. “We stay on formulary as much as possible, keep less effective drugs off formulary, and use our financial counselors and pharmacists to help reduce patient cost,” shared one medical director.
Yet respondents recognize that drug costs are only one driver of the escalating cost of care and that the issue is nuanced. “Affordability of care requires two conversations: total cost of care to the system, and then the affordability for the patient,” said another medical director.
Additional Financial Issues
In another continuing trend, respondents reported that lack of reimbursement for supportive care services, such as patient navigation, survivorship care planning, and financial counseling, which are key elements of patient-centered care, remains a critical issue (66%). “While ACCC member cancer programs have made great strides in advancing patient-centered care, it’s clear that payer policies are lagging behind,” said ACCC President Jennie R. Crews, MD, MMM, FACP. “Reimbursement for these services is especially critical as we transition to new models of cancer care delivery such as the Oncology Care Model and the Merit-Based Incentive Payment System.”
In alignment with the drive to empower patients, respondents cited the need for increased transparency in commercial insurance policies so that patients can readily understand which services plans do—and do not—cover (64%). While waiting to see what will happen under the new Administration, ACCC member programs continue to lead efforts in cost transparency.
“[We] have put together a cost transparency group to determine how we can provide education and assistance to patients who have been prescribed high-cost chemotherapies or immunotherapies,” said one cancer program administrator.
Finally, providers challenged by a turbulent, ever-changing health-care landscape and burdened by an increasing number of mandatory reporting programs are citing a critical need for “physicians and midlevel providers to focus on direct patient care—not paperwork” (55%). In the words of one radiation oncologist, “Paperwork continues to increase and takes away from the doctor–patient interaction.” An oncology nurse shared a similar concern: “Payers should work with those in the trenches [providers] to make precertifications easier..., get nonclinical personnel off the phones, and let providers speak with decision-makers.”
The 2016 survey results show that ACCC Member Cancer Programs continue to employ innovative strategies to reduce costs while ensuring quality care, including:
“[We] are adding a hospitalist to our inpatient services to allow for better coverage; planning a symptom management clinic to prevent unnecessary wait times in emergency departments and hospitalizations,” said a cancer program administrator. One medical director shared some of the strategies his program has implemented, such as, “Nurse navigators who coordinate care. Extended hours—we now provide urgent care throughout the day. Our financial counselors meet with almost every patient.”
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®.