How to improve access, efficiency and equity in tomorrow's cancer programs

Cancer centers around the country are reaching capacity while facing challenges such as higher-acuity patients, labor shortages and consumer-like expectations.

To successfully meet the needs of tomorrow's cancer patients and their families, providers must embrace new and proven strategies that increase their geographical reach, address the needs of under-served populations and optimize their performance.

In a featured session sponsored by ECG Management Consultants at Becker's Healthcare Oncology Virtual Event, seven oncology experts discussed how to improve access, efficiency and equity in oncology programs. Panelists were:

  • Sachin Apte, MD, chief clinical officer, Huntsman Cancer Institute (Salt Lake City, Utah)
  • Lili Hay, manager, ECG Management Consultants
  • Kathy LaRaia, executive director of oncology services, Munson Healthcare (Traverse City, Mich.)
  • Harlan Levine, MD, president of health innovation and policy, City of Hope (Duarte, Calif.)
  • Kathi Mooney, PhD, RN, chair of nursing and co-leader of cancer control and population sciences, Huntsman Cancer Institute (Salt Lake City, Utah)
  • Meagan O'Neill, senior manager, ECG Management Consultants
  • Matt Sturm, principal, ECG Management Consultants

Five key takeaways were:

1. Many cancer programs are at capacity and must create a road map for the future. "Over the last 20 years, many organizations have developed and scaled successful cancer programs to meet community needs," Mr. Sturm said. "However, many are reaching capacity and need to move their program to the next level." Management must decide how to meet changing patient needs and expectations, as well as maximize developments in technological and clinical capabilities.

2. Six pillars are required to pioneer tomorrow's cancer programs.

  • Patient navigation. According to Ms. Hay, most cancer center’s current navigation functions are targeted to particular disease sites or geographic locations, which often leads to fragmented care. "Patient navigation in the future should be a more comprehensive function," she explained. "It should start with screening, work through primary care, move to the cancer center, and follow through to survivorship."
  • Health equity. "While the United States has made tremendous progress over the last two decades against cancer, this has not equally benefitted all populations," Ms. Hay said. ECG offers tangible, tactical steps to help providers address health equity issues such as rebuilding connection and trust with communities and helping underserved populations navigate the healthcare system.
  • Alternate care models. By working closely with urgent care centers, using electronic patient reported outcomes and offering home infusions services, providers can improve care and reduce ER visits.
  • Performance optimization. "Screening delays resulting from the COVID pandemic mean we expect a volume influx in the future," Ms. O'Neill said. "Unfortunately, patients are presenting at higher acuity and complexity and are being diagnosed in later stages." To be ready, programs must consider tools that can help optimize performance like scheduling templates and referral management.
  • Academic partnerships. Providers should match their goals with potential academic partners to ensure the relationship will be mutually beneficial and sustainable.
  • Digital health. Before providers are able to use digital health to influence the patient care experience, systems need to first have the right data infrastructure in place to allow for collection of data in the most accurate and comprehensive way possible, followed by a focus on optimizing business operations.

3. Huntsman Cancer Institute has implemented Huntsman at Home™, an oncology hospital at home program, successfully reducing emergency room visits, hospitalizations and patient costs. In 2018, Huntsman began a home hospital program within a 20-mile radius and expanded it to rural areas in 2021, covering counties two to five hours away. "We found that home hospital patients had a 55 percent reduction in unplanned hospitalizations, and if they were hospitalized, their stay was shortened by one day," Dr. Mooney said. "We also found a 45 percent reduction in emergency department use and a 47 percent reduction in patient charges when compared to usual care."

Dr. Apte shared Huntsman's future plans: "We want to focus next on operational efficiency. We want our nurse practitioners to work at the top of their license, capture more revenue, reduce patient length of stay and increase the acuity of our patients. We'd also like to continue to scale our geographic reach with the same resources."

4. Munson Healthcare provides cancer care close to home using a hub-and-spoke model. "We embarked on developing a regional cancer network in 2015 to improve access to care for the rural communities we serve," Ms. LaRaia said. "At each one of our regional centers, we now have an advanced practice provider who provides daily clinical oversight and helps coordinate care, treatment and tests." Each location has between six and 12 infusion chairs with supporting staff. "We've actually been able to treat more than 4,000 new patients and get them started in their care close to home," she added.

5. City of Hope is working to provide optimal cancer care to all, regardless of geography and social standing. "The widening gap between optimal care and standard care results in huge variation when it comes to survival outcomes, which is even more dramatic for minorities," Dr. Levine said. "We simply could not accept the status quo, so we set out to help cancer patients get access to optimal care, regardless of geography, whether they work in a boardroom or the mailroom."

AccessHope remotely connects employees, families and community oncologists to multidisciplinary specialists with National Cancer Institute Designated Comprehensive Care Centers. "Our services are influencing the course of treatment in more than 80 percent of our cases," Dr. Levine said. "While our focus is on improving outcomes and patient experience, our net promoter score is over 80. It turns out, we're also saving our customers money, leading to a very strong value proposition." AccessHope serves approximately 3.5 million plan members through employers, including 39 Fortune 1000 companies.

By adhering to the six pillars established by ECG, cancer centers can successfully meet the changing needs of patients, providers and families fighting cancer in the future.

To learn more about Becker's virtual events, click here.


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