Association of Community Cancer Centers Releases Report: Trending Now in Cancer Care 2020

Oncology Programs Report COVID’s Impact Staffing, Operations, Research, Telehealth, Health Equity and Revenue

Rockville, MD — The Association of Cancer Care Centers (ACCC) announced today the release of Trending Now in Cancer Care 2020, an annual report that identifies current and emerging trends in cancer programs across the country. The detailed report presents findings from focus groups that illuminate the short- and long-term impact of COVID-19 on cancer care programs and professionals.

Since 2009, ACCC has fielded an annual Trending Now in Cancer Care survey. This year, due to demands on the healthcare team during the pandemic, ACCC chose instead to conduct focus groups to better capture the lived experiences of the most urgent issues impacting oncology practice and care delivery. Topics discussed included staffing and operational integrity, service line delivery and revenue optimization, telehealth and supportive technology, clinical research, and health equity. Participants were candid in how the global pandemic tested operational, professional, and personal resilience and transformed clinical and personal communication.

“This report is critically important and unlike any other, in that we are able to identify the impact of the pandemic on cancer programs and their staff, and tailor our resources to incorporate the lessons learned over the past year,” said Krista Nelson, MSW, LCSW, OSW-C, FAOSW, ACCC President and Program Manager of Quality and Research, Cancer Support Services & Compassion for the Providence Cancer Institute in Portland, Oregon. “Feedback from members reaffirmed ACCC’s commitment to focus on education and resources to promote equity, diversity, and inclusion within oncology, and build a culture of resilience for cancer care staff.”

Major findings of Trending Now in Cancer Care 2020:

• COVID-19 took a heavy toll on cancer care staff and providers. Many contracted COVID-19 or experienced financial hardship due to furloughs and layoffs. Those working reported burnout, exhaustion, fatigue, and stress. Physical distancing contributed to social and emotional isolation for cancer care staff and patients; providing support for staff became a full-time occupation for many managers and leaders.
• Cancer screening dropped sharply and has yet to resume pre-pandemic levels. During the height of the pandemic, screening sites closed, and primary care providers did not offer screening appointments. Patients canceled regular exams and avoided the ER, reducing the potential for incidental findings of cancer. Many providers believe that the dramatic reductions in screening and preventive appointments may lead to cancers being diagnosed at later stages. ACCC focus group participants shared that tumor registries will likely record more advanced cancers in 2021 and even beyond.
• The U.S. healthcare system took a financial hit. Some health systems stopped outpatient or scheduled appointments and suspended entire service lines. Reductions in overall patient volume and elective procedures adversely impacted revenue. Because cancer patients in active treatment kept their clinic visits, oncology programs often shored up health system revenue.
• Cancer programs adopted telehealth virtually overnight. In spring 2020, virtual visits accounted for about 40% of patient volume, increasing to almost 50% during the fall. While telehealth has shown the potential to improve access to those in rural areas, a very real digital divide meant that telehealth did not benefit all patients equally. Many patients in rural or impoverished areas lacked cell phone minutes, cell phone service, connectivity, and privacy.
• The pandemic stimulated a nationwide discussion to address health inequities. COVID-19 exacerbated existing disparities in oncology along socioeconomic, racial and ethnic, age, gender, and geography divides. Cancer programs responded by scheduling flexible clinic and treatment hours for working patients; increasing transportation support for treatment visits; addressing food insecurity and childcare needs; and partnering with community organizations to reach at-risk individuals. ACCC also reported that new-found flexibilities in clinical research during the pandemic may have long-term potential to reshape the design and conduct of clinical trials and address health inequities.

The report—and related resources—can be viewed online at the ACCC website and in the latest Oncology Issues journal. Visit the website for a related podcast on the impact of COVID-19 on revenue optimization.