ACCC 2018 Survey Finds Multiple Barriers to Cancer Program Growth
At a time of unprecedented advances in the science of cancer, growing complexity in cancer treatments, and ongoing health policy fluctuation, the Association of Community Cancer Centers (ACCC) 9th annual Trending Now in Cancer Care survey reveals how cancer programs across the country are being impacted by pressure from turbulence in multiple sectors: payers, government, and industry. The survey, conducted in partnership with the Oncology Roundtable, was carried out in July and August 2018 and received more than 200 responses.
Top Threats and Opportunities
Ranking the top threats to future cancer program growth, survey responses give nearly equal weight to barriers from three sectors: nearly half (48%) name reimbursement requirements from payers, 48% cite cost of drugs and/or new treatment modalities, and 40% find uncertainties in drug pricing reform policies a top threat.
“ACCC’s Trending Now in Cancer Care survey provides much-needed perspective on strengths and challenges experienced by cancer programs across the country,” said ACCC President Tom Gallo, MS, MDA. “Despite the barriers and pressures programs face, survey results show continued progress in delivery of patient-centered cancer care.”
Respondents’ selections for top opportunities for return on investment were often the areas of focus for improving patient-centered care delivery:
- Care coordination (45%);
- More subspecialists (44%);
- Symptom management (36%);
- Screening services (30%).
Respondents listed symptom management (54%) and care coordination (41%) among the top five opportunities for cost savings.
Other Survey Findings
Results of the 2018 survey show that the promise of electronic health records (EHRs) for streamlined communication and increased efficiency remains unrealized. While 69% of respondents reported their EHRs either “significantly improved” or “somewhat improved” care coordination, nearly 70% said EHRs have made physician and staff workdays longer. Almost half (49%) feel that EHRs have had a negative impact on provider-patient interactions.
At the same time, telehealth is establishing a foothold in cancer care. Among respondents, 35% use telehealth for genetic counseling, 20% for oral chemotherapy adherence education and support, and 19% for symptom management consults. In the next 2 years, 33% say they will integrate telehealth for survivorship visits, 29% for genetic counseling, and 28% for oral chemotherapy adherence education and support. Telehealth would also help address one of the major barriers to access to care: transportation. More than two-thirds of survey respondents (67%) said they partner with an organization to provide transportation for patients, with another 37% implementing their own transportation program to ensure patients can get to their treatment visits. Leading barriers to expansion of telehealth are reimbursement (70%) and operational challenges such as staffing or technology requirements (64%).
Most responding cancer programs (79%) reported being “very concerned” or “somewhat concerned” about patients refusing treatment due to financial worries; nearly half (49%) said they have had a patient refuse treatment because of financial worries in the past 12 months. The 2018 survey shows cancer programs are working to reduce patient financial distress; 81% have dedicated financial advocacy staff to help patients and families address economic barriers to care.
While precision medicine is the future of cancer treatment and offers the promise of improved patient outcomes, cancer care providers face numerous challenges to delivering this type of care to their patients. For example, targeted therapies and immunotherapies for cancer increasingly require biomarker testing, yet survey respondents said that barriers such as insurance coverage (68%) and payer reimbursement requirements (63%) hinder their ability to conduct biomarker testing. Nearly three-fourths (72%) of respondents reported that cost and reimbursement are the greatest challenges to offering immunotherapy treatments.
“The data provided in this survey is a launchpad for ACCC throughout the year as we develop programs and resources to meet member needs and respond to changes in the health-care environment,” said Mr. Gallo.
About the Survey
The Oncology Roundtable and the Association of Community Cancer Centers (ACCC) partnered to collect information on the key issues affecting cancer care providers across the country. The survey was distributed via email on July 9, 2018; participation was restricted to cancer program administrators and providers. A total of 205 people from 161 organizations submitted responses over the subsequent 6 weeks. View highlights, summary, and analysis of survey results at accc-cancer.org/trends.
Disclosure: Pfizer Oncology provides funding and support to ACCC for the Trending Now in Cancer Care survey.
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®.
