Policy Challenges and Opportunities to Address Changing Paradigms in Cancer Care Delivery

Abstract

Multiple factors are forcing the healthcare delivery system to change. A movement toward value-based payment models is shifting these systems to team-based integration and coordination of care for better efficiencies and outcomes. Workforce shortages are stressing access and quality of care for patients with cancer and survivors, and their families and caregivers. Innovative therapies are expensive, forcing payers and employers to prioritize resources. Patients are advocating for care models centered on their needs rather than those of providers. In response, payment policies have recently focused on the promotion of alternative payment models that incentivize coordinated, high-quality care with consideration for value and controlling the increasing overall costs associated with cancer and its treatment. Given the multitude of factors confounding cancer care, NCCN convened a multistakeholder working group to examine the challenges and opportunities presented by changing paradigms in cancer care delivery. The group identified key challenges and developed policy recommendations to address 4 high-visibility topics in cancer care delivery. The findings and recommendations were then presented at the NCCN Policy Summit: Policy Challenges and Opportunities to Address Changing Paradigms in Cancer Care Delivery in September 2018, and multistakeholder roundtable panel discussions explored these findings and recommendations along with additional items. This article encapsulates the discussion from the NCCN Working Group meetings and the NCCN Policy Summit, including multistakeholder policy recommendations on delivery issues in cancer care designed to help inform national policies moving forward.

Exploring Social Support Networks and Interactions of Young Adult and LGBTQIA+ Cancer Survivors and Care Partners

“…This is especially critical for underserved populations, including people who are YA and LGBTQIA+ cancer survivors or care partners, who may be even more reliant on their personal social networks who feel disconnected from typical, formal support resources, and whose support systems may look different than those represented in the cancer literature. Finding ways to better coordinate holistic, high-quality cancer care is a national priority (59). Conducting more inclusive survivorship research will be important to ensure health care policy remedies, rather than reinforces, health care disparities.…”

Cervical Cancer Self Management Education (CSME) meningkatkan kualitas hidup pasien dengan kanker serviks

“…Selain itu, WHO juga menghormati otonomi pasien dalam membuat pilihan dan mengambil peran aktif dalam menyusun rencana pengelolaan gejala (Damasceno, 2016). Kebijakan Kanker Nasional yang disponsori oleh Institute of Medicine menekankan bahwa manajemen gejala sebagai kebutuhan penting untuk meningkatkan perawatan pasien kanker (Winckworth-Prejsnar et al, 2019). Hasil penelitian mengungkapkan bahwa program manajemen diri penyakit kronis di seluruh dunia (Amerika Serikat, Cina, Taiwan, Australia) dapat meningkatkan hasil kesehatan.…”

Thematic Analysis of Challenges of Care Coordination for Underinsured and Uninsured Cancer Survivors With Chronic Conditions

“…Countervailing forces of clinical complexity, payment reform, and health information technology innovations have increased expectations for efficiency and effectiveness. 2 Movement toward value-based care by the Centers for Medicare & Medicaid Services and other payers increasingly holds clinicians accountable through guideline-based bundled payments 3 , 4 and risk-based reimbursement, with substantial implications for optimal care of noncancer comorbidities such as diabetes and hypertension. 5 , 6 As more clinicians become involved in cancer treatment, surveillance, and survivorship care, communication across multiple clinical teams becomes increasingly difficult, and care coordination can be jeopardized.…”

“…Care delivery for cancer survivors with cooccurring chronic conditions is changing rapidly. Countervailing forces of clinical complexity, payment reform, and health information technology innovations have increased expectations for efficiency and effectiveness . Movement toward value-based care by the Centers for Medicare & Medicaid Services and other payers increasingly holds clinicians accountable through guideline-based bundled payments and risk-based reimbursement, with substantial implications for optimal care of noncancer comorbidities such as diabetes and hypertension .…”