In 1974, a small group of physicians seeking to dispel the myth that community physicians were uninterested in and incapable of participating in state-of-the-art cancer care came together to form the Association of Cancer Care Centers (ACCC). ACCC would become the mechanism through which clinical protocols and other oncology standards of care were developed and disseminated to community cancer programs across the nation. Led by ACCC, the community oncology care provider would emerge as an equal partner in the war against cancer.
In the early 1970s, ACCC was steadfast in calling for increased government funding for the National Cancer Institute’s (NCI’s) Cancer Centers Program to increase research opportunities for community cancer programs across the country. ACCC organized an effective network of community oncologists to educate their representatives in Congress about community cancer care issues. Led by ACCC, hospitals across the country began to apply for planning grants in their communities. ACCC leaders believed that further NCI funding for community clinical research would be limited without increased community participation within the ranks of NCI itself. In 1978, Congress renewed the National Cancer Act, which was amended to include, for the first time, an emphasis on community care. The Act also called for community representation on the National Cancer Advisory Board.
In 1981, ACCC’s Ad Hoc Clinical Research Committee helped facilitate clinical trials dialogue with NCI. The committee promoted a mechanism that would elevate community physicians as equal partners in clinical research with their university colleagues. In 1982, NCI responded with the Community Clinical Oncology Program.
By the 1980s the membership of ACCC, an organization founded by oncologists, began to reflect the multidisciplinary nature of oncology care. During this decade, ACCC's membership grew to include medical and radiation oncologists, oncology nurses, hospital and practice administrators, medical directors, radiation therapists, oncology pharmacists, social workers, and cancer registrars employed in a variety of settings, including hospitals, physician practices, hospice and home care, and freestanding cancer centers.
ACCC developed into the only national organization promoting the collective concerns of the multidisciplinary oncology team as a whole. Beginning with its first annual meeting in 1974, ACCC has facilitated multidisciplinary oncology collaboration in a variety of forums dedicated to diverse aspects of cancer program management.
In the 1980s, the economics of oncology began to change. With the advent of the DRG reimbursement system and the growth of managed care, site of care for most cancer diagnoses shifted to the more economical outpatient hospital setting and physician practices. Keeping the multidisciplinary aspect of oncology care intact in all treatment settings would become a major ACCC priority.
During this decade, community cancer programs were being developed across the country. ACCC recognized the need to establish a set of standards that would provide members with guidance on just how to go about setting up oncology programs. ACCC’s Standards for Cancer Programs (later re-named ACCC Cancer Program Guidelines) was published in 1988 and has been updated many times since.
Throughout the 1990s, ACCC worked tirelessly to overcome reimbursement difficulties related to off-label uses of FDA-approved drugs and advocated for patients who were denied access to therapies. Concurrently, ACCC advocated for payer coverage of the patient care costs of clinical trials.
The first decade of the 21st Century saw tremendous opportunities in cancer biology and genetics, offering potential for significant changes in what cancer providers could do for their patients. Yet these advances occurred against a backdrop of payer restrictions that could seriously hinder the ability to deliver quality cancer care. ACCC worked to ensure that cancer patients received the care they needed in their communities, and expanded its reach through educational programs, publications, and advocacy efforts, to help the multidisciplinary team of oncology professionals.
In the early 2000s ACCC advocated tirelessly for adequate reimbursement of drugs delivered in the outpatient setting. In 2003, President Bush signed into law the Medicare Prescription Drug, Improvement and Modernization Act, revamping the program and introducing average sales price (ASP) methodology for drug reimbursement.
In 2004 ACCC celebrated 30 years of service. With adequate drug reimbursement top of mind for its membership, ACCC recognized that pharmacists were critical to these efforts and created the Oncology Pharmacy Education Network (OPEN). Before ASP went into effect in 2005, ACCC lobbied successfully for an add-on payment to account for overhead pharmacy costs.
With rising drug costs significantly impacting patient access to care, ACCC developed and made available to members an annual Patient Assistance and Reimbursement Guide. In addition to financial advocacy, ACCC promoted patient-centered care, with targeted education in areas like patient navigation and cancer survivorship.
The Patient Protection and Affordable Care Act (ACA) was signed into law by President Obama on March 23, 2010, kicking into high gear the transition to value-based care with the introduction of accountable care organizations (ACOs) and a CMS Innovation Center, which subsequently rolled out the Oncology Care Model in 2016. ACCC developed education and resources to help its member programs successfully transition to value-based care, including the ACCC OCM Coalition, which later transitioned to the broader ACCC Alternative Payment Models Coalition.
The annual ACCC Innovator Awards program was launched in 2011 to honor Cancer Program Members for their ingenuity and pioneering achievements in oncology. Innovations advance the goals of improving access, quality, and value in cancer care delivery.
In 2012 ACCC launched its Financial Advocacy Network to develop education, tools, and resources to support all cancer program staff responsible for helping patients navigate the financial issues surrounding cancer care delivery.
ACCC celebrated 40 years of service in 2014, continuing its focus on helping its membership improve the delivery of patient-centered care, developing resources and education in areas like adolescent and young adult cancer care, distress screening, onco-fertility, geriatric care, and palliative care.
In 2015, ACCC launched the Institute for Clinical Immuno-Oncology, the first initiative to guide the multidisciplinary care team’s adoption of immuno-oncology (IO) in community cancer settings across the country.
In 2019 OPEN celebrated 15 years, and ACCC continued its advocacy efforts around key issues like brown- and white-bagging, step therapy, and pharmacy benefit managers.
When the COVID-19 pandemic hit in 2020, ACCC pivoted overnight to develop tools and resources to help its members redefine how they work while keeping their patients and staff safe during a global pandemic.
ACCC continues its ongoing commitment to advancing equitable access to quality comprehensive cancer care for all, including access to cancer clinical trials.
In 2020, ACCC and ASCO (the American Society for Clinical Oncology) joined forces in a collaborative to increase participation in cancer treatment trials, with a focus on increasing participation in patients from historically underrepresented racial and ethnic communities. Seventy-five research sites are participating in the pilot project, which aims to help ensure racial and ethnic diversity among clinical trial participants and support for clinicians to routinely offer clinical trials to all eligible patients.
In 2021 the ACCC Community Oncology Research Institute (ACORI) was created to build on this mission, rolling out tools like the Clinical Research Terms Glossary and resources like the ACORI Call to Action Summit, a virtual event co-hosted with Stand Up to Cancer to identify concrete strategies for engaging patients, caregivers, and their communities to strengthen oncology research across the United States.