A new report, published by the American Society of Clinical Oncology (ASCO) in the Journal of Oncology Practice and presented in part via a live Webcast in Washington, DC, outlined the current and future challenges of cancer care in the United States. An increasing cost of care and demand for quality care, growing cancer patient and cancer survivor populations, and a decreasing oncology workforce are all contributing to a challenging environment for cancer care.
The report, “The State of Cancer Care in America, 2014,” also provides recommendations for monitoring and addressing the changes and challenges in oncology care.
“We are not just here to highlight problems,” said Clifford Hudis, MD, ASCO president and medical oncologist at Memorial Sloan-Kettering Cancer Center in New York City, during the Congressional briefing Webcast. “What we want is to develop solutions.”
“US cancer care has led innovation, but it faces a near perfect storm of challenges that could threaten its sustainability and, specifically at a grassroots level, its access to good care,” Hudis added.
Hudis outlined three concrete steps to address the current headwinds for across-the-board quality care in oncology.
First, new healthcare delivery and payment models should be developed and tested, which can preserve and sustain viable small community practices. They should both reward and encourage quality care.
Second, the cyclical threat to all cancer centers, including small community practices, due to cuts in Medicare payments to physicians as a result of the sequester, should be stopped. Hudis called for a repeal of the sustainable growth rate (SGR) formula under the Medicare reimbursement system, which results in a “huge unfunded component dangled every year that leads to threats of payment cuts every year to clinicians,” he said.
Bipartisan Congressional committees have recently introduced the SGR Repeal and Medicare Provider Payment Modernization Act of 2014, which would eliminate the flawed SGR system and would provide special support for practices in underserved areas. It would also support innovative healthcare payment, delivery, and quality initiatives, according to the ASCO report.
Third, physician-led quality initiatives should be implemented, including ASCO’s CancerLinQ and the Quality Oncology Practice Initiative (QOPI), which are under development. While consumer information and news are digitally distributed and accessible on any smart device globally, “we in medicine have lagged behind in this revolution,” said Hudis, who called CancerLinQ a groundbreaking attempt to overcome these technology and communication hurdles.
CancerLinQ is a rapid learning system model in development. An operational prototype was launched in 2013. CancerLinQ aims to become a network of cancer care information that can be used in real time to see how other clinicians are treating their patients and their outcomes.
“CancerLinQ will form the foundation for a quality-based payment initiative. As we think about new payment delivery models, we would like to change the way we deliver cancer care, but this has to be coupled with quality reporting metrics. QOPI and CancerLinQ are the future, and may become so for other specialties as well,” said Blase Polite, MD, of the University of Chicago Medicine, during his presentation. Rather than having valuable individual patient care results and progress in silo databases at individual oncology offices, CancerLinQ would integrate this valuable information to be accessed by all oncologists.
“What we want to do is deliver back to point of care, quality measures, and metrics benchmarking against standards and guidelines, so that patients anywhere can have access to state-of-the-art care,” said Hudis.
See ASCO Cites Multiple Pressures on Cancer Care for part I of our coverage of the State of Cancer Care in America, 2014: A Report by the American Society of Clinical Oncology.