ACCC 2016 Survey Finds Cancer Drug Costs Remain the Most Critical Challenge to Care

Cost selected as top challenge by HCPs; up nearly 50% compared to 2015 survey

Rockville, Md. — As more cost pressures are placed on the healthcare system and the transition to value-based care gains momentum, the Association of Cancer Care Centers (ACCC) seventh annual Trends in Cancer Programs survey reveals critical challenges and emerging trends at U.S. cancer programs. The costs of cancer drugs was named the top challenge by 2016 survey respondents (83%) — nearly double (45%) the number of respondents from last year’s survey. ACCC member programs are meeting this challenge head on. “We stay on formulary as much as possible; keep less effective drugs off formulary; use our financial counselors and pharmacists to help reduce patient cost,” shared one medical director. Yet respondents recognize that drug costs are only one driver of the escalating cost of care, and that the issue is nuanced. “Affordability of care requires two conversations: total cost of care to the system and then the affordability for the patient,” said another medical director.

In another continuing trend, respondents report that lack of reimbursement for supportive care services, such as patient navigation, survivorship care planning, and financial counseling, which are key elements of patient-centered care, remains a critical issue (66%). “While ACCC member cancer programs have made great strides in advancing patient-centered care, it’s clear that payer policies are lagging behind,” said ACCC President Jennie R. Crews, MD, MMM, FACP. “Reimbursement for these services is especially critical as we transition to new models of cancer care delivery such as the Oncology Care Model (OCM) and the Merit-Based Incentive Payment System (MIPS).”

In alignment with the drive to empower patients, respondents cited the need for increased transparency in commercial insurance policies so that patients can readily understand what services plans do—and do not—cover (64%). While waiting to see what will happen under the new Administration, ACCC member programs continue to lead efforts on cost transparency. “[We] have put together a cost transparency group to determine how we can provide education and assistance to patients who have been prescribed high-cost chemotherapies or immunotherapies,” shared one cancer program administrator.

Finally, providers challenged by a turbulent, ever-changing healthcare landscape and burdened by an increasing number of mandatory reporting programs are citing a critical need for “physicians and mid-level providers to focus on direct patient care—not paperwork” (55%). In the words of one radiation oncologist, “Paperwork continues to increase and takes away from the doctor and patient interaction.” An oncology nurse shared a similar concern, “... Payers should work with those in the trenches [providers] to make pre-certifications easier ... Get non-clinical personnel off the phones and let providers speak with decision makers.”

The annual ACCC Trends in Cancer Programs survey provides key insight into nationwide developments in the business of cancer care. The 2016 survey results show that ACCC Member Cancer Programs continue to be at the forefront of healthcare reform, employing innovative strategies to reduce costs while ensuring quality care, including:

• Lean initiatives focused on streamlining processes and improving quality of care (62%)
• Working with physicians to reduce unnecessary hospitalizations (60%)
• Adding services, including oncology rehabilitation, nurse call centers for symptom management, and nurse practitioner-based survivorship care (57%)

“[We] are adding a hospitalist to our inpatient services to allow for better coverage; planning a symptom management clinic to prevent unnecessary wait times in EDs and hospitalizations,” said a cancer program administrator. One medical director shared some of the strategies his program has implemented, such as, “Nurse navigators who coordinate care. Extended hours—we now provide urgent care throughout the day. Our financial counselors meet with almost every patient.”

As a next step, ACCC has used the critical challenges and emerging trends identified in its 2016 survey to shape the agenda for its upcoming 43rd Annual Meeting, CANCERSCAPE, March 29-31, 2017, in Washington, DC. ACCC members will come together to learn from insiders, experts, and decision makers about evolving healthcare policy trends, alternative payment models, value-based frameworks, data collection and quality measures, and more. An important part of these conversations: identifying practical strategies and solutions to help prepare our cancer programs for the sweeping healthcare changes that are almost certain to come.