ASCO Releases Its State of Cancer Care in America: 2017 Report
In a press briefing today on Capitol Hill, ASCO presented its fourth annual State of Cancer Care in America: 2017 report, which found that although the cancer care delivery system in the United States is undergoing profound changes to better meet the needs of cancer survivors, persistent hurdles threaten to slow progress. The report, which was published in the Journal of Oncology Practice, cited key areas of advances made in oncology care that have led to increased numbers of cancer survivors, including new approaches for cancer diagnosis and treatment, improved data-sharing to drive innovation, and an increased focus on value-based health care. However, the report also details the challenges that lie ahead, including access and affordability to care and increased burdens on oncology practices, which threaten high-value, high-quality cancer care for patients and offers recommendations to ensure patient access to high-quality cancer care.
Confronting Challenges on Multiple Fronts
According to the report, several factors are contributing to a record number of people living with and surviving cancer, including a growing U.S. population that is changing demographically and living longer and advances in cancer treatments. Over the next 10 years, the number of cancer survivors in the United States is expected to grow from 15.5 million to 20.3 million and to 26.1 million by 2040.
“Since 1991, we’ve been able to save 2.1 million lives because of significant advances in prevention, diagnosis, and treatment, something unimaginable even a decade ago,” said ASCO President Daniel F. Hayes, MD, FACP, FASCO, in a statement. “But there’s still more work to be done to ensure that every patient with cancer, no matter who they are or where they live, has access to high-quality, high-value cancer care.”
The ASCO report highlights the barriers to achieving high-value, high-quality cancer care, including patient financial distress due to the high cost of cancer treatments, even among those with health insurance; continued health-care disparities that impact patient outcomes; and increasing administrative burdens placed on oncology practices that divert critical time and resources from their patients.
According to the report’s findings, more than half of oncology practices surveyed identified increasing administrative and overhead costs as a top pressure—a trend that was even greater in physician-owned practices. In 2016, said the report, practices from common medical specialties spent a total of $15.4 billion and an average of 785 hours per physician annually to meet reporting requirements. To address these challenges, the oncology workforce is evolving to include more nonphysician providers, including advanced practice providers, nurses, and genetic counselors.
Improving the Lives of Cancer Survivors
Despite these challenges, the ASCO report found there is much to be optimistic about in improving the lives of cancer survivors, including treatment advances; increased funding for the Beau Biden Cancer Moonshot Initiative and the National Institutes of Health Precision Medicine Initiative; and the approval of 16 new and expanded use cancer therapies by the U.S. Food and Drug Administration (FDA), along with two first-ever cancer diagnostic tests: a liquid biopsy test for lung cancer mutations and a sequencing test to identify patients with advanced ovarian cancer eligible for a specific cancer treatment.
The report also cited the emergence of big-data initiatives, including ASCO’s CancerLinQ®, as a contributing factor in improving cancer care delivery and patient outcomes and credits the Centers for Medicare & Medicaid Services’ (CMS) implementation of the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) with improving progress toward value-based cancer care delivery.
ASCO’s Vision for the Path Forward
In the State of Cancer Care in America report, ASCO set forth the following recommendations as a policy framework to strengthen the current health-care system and ensure patients’ access to high-quality cancer care in the future:
- Health insurance for all people with cancer that provides access to high-quality cancer care delivered by a cancer specialist. ASCO also released a set of health-care reform guiding principles as a framework for strengthening the cancer care delivery system.
- Federal funding of the National Cancer Institute and FDA to provide adequate funding and infrastructure support for cancer research and adequate resources for the FDA to review and approve the safety and efficacy of cancer therapies and diagnostics efficiently and quickly.
- To achieve payment reform as the nation moves from a volume-based to a value-based health-care reimbursement system, ASCO is calling on public and private payers to work with oncology providers and patients to develop new payment models that support patient-centered cancer care across care delivery settings. In addition, ASCO asks CMS to support the testing of multiple payment models in oncology, including ASCO’s Patient-Centered Oncology Payment Model, as potential alternative payment models for oncology care.
- Electronic health record interoperability to reach the full potential of cancer-specific rapid learning health systems and accelerate the pace of cancer research progress. To achieve this goal, ASCO asks for the implementation of the 21st Century Cures Act to promote the interoperability of electronic health records and prevent information blocking.
- Reducing administrative burden through streamlining and standardizing documentation and reporting requirements, so oncology professionals are able to focus adequate time and resources on their patients.
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®.
