Resource and Reimbursement Barriers to Comprehensive Cancer Care Delivery: An Analysis of Association of Community Cancer Centers Survey Data

Overview

Journal JCO Oncol Pract

Specialty Oncology

Date 2022 Dec 15

PMID 36521094

Authors

Al Bowen Benson 3rd

Leigh Boehmer

Xinlei Mi

Masha Kocherginsky

Latha Shivakumar

Julia R Trosman

Christine B Weldon

Ya-Chen Tina Shih

Elizabeth A Hahn

Sheetal M Kircher

Affiliations

Soon will be listed here.

Abstract

Purpose: Comprehensive cancer care (CCC) delivery is recommended in guidelines and considered essential for high-quality cancer management. Barriers, such as insufficient reimbursement, prevent consistent access to and delivery of CCC. Association of Community Cancer Centers conducted a national survey to elucidate capacity and barriers to CCC delivery to inform policy and value-based payment reform.

Methods: Survey methodology included item generation with expert review, iterative piloting, and cognitive validity testing. In the final instrument, 27 supportive oncology services were assessed for availability, reasons not offered, and coverage/reimbursement.

Results: 204 of 704 member programs completed survey questions. Despite most services being reported as offered, a minority were funded through insurance reimbursement. The services least likely to obtain reimbursement were those that address practical and family/childcare needs (0.7%), caregiver support (1.5%), advanced care directives (1.7%), spiritual services (1.8%), and navigation (2.7%). These findings did not vary by region or practice type.

Conclusion: There is a lack of sufficient reimbursement, staffing, and budget to provide CCC across the United States. Care models and reimbursement policies must include CCC services to optimize delivery of cancer care.

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