In recent years, oncology clinic staff have experienced a steady rise in the number of phone calls that they receive from patients and families each day. There are many factors contributing to this increase including, the shift of cancer care into the outpatient setting, growing treatment complexity, and rising use of oral therapies. Ensuring that patients and families’ concerns are addressed in a timely way is an essential component of high quality cancer care, yet due to the sheer volume of calls, it is becoming increasingly difficult for clinic staff to manage incoming phone calls along with their many other duties.
In order to help members manage increasing call volumes, the Oncology Roundtable undertook a review of recent journal articles on the topic. Key findings and analysis are summarized below.
Clinic telephone call benchmarks and lessons for management
A study published this week in the journal Cancer found that cancer surirvors are more likely than other patients to forgo care due to costs. The findings come from a survey of over 110,000 people conducted between 2003 and 2006. According to the Washington Post, "Survey participants were asked if they had needed medical care in the previous year but didn't get it because they couldn't afford it. Cancer survivors younger than 65 were between 1.5 and 2 times more likely to have said yes to that question than those who hadn't had cancer." Specifically, 8% of cancer survivors reported forgoing medical care, 10% did not fill prescriptions, 11% put off dental care, and 3% postponed mental health services.
These findings are perhaps not so surprising in light of the enormous costs incurred during cancer treatment. In our State of the Union presentation last year, we reported data from the Kaiser foundation, which found that insured patients spend an average of $35,000 out-of-pocket on their illness, and 20% of insured patients spend all or most of their savings.
We will be studying survivorship for our upcoming National Meeting series, including strategies that cancer programs can employ to ensure that even patients who have exhausted their financial resources receive proper care. If you have questions about survivorship program development, or would like to participate in the research, please do not hesitate to contact me directly at email@example.com.
Cancer Survivors May Be More Likely to Forgo Care Due to Cost
A new study released by the CDC indicates the cost of cancer care will double in the next 20 years. This in and of itself is not news. What's interesting about the CDC's findings is the key drivers of the cost growth - they found that it is rising patient volumes NOT the cost of treatment itself, that will be the key growth driver. And the rising cost of cancer care is in line with growth in total medical expenditures - so it is not outsized, which we are often led to believe.
Other findings of note:
- Cancer accounts for 5% of total U.S. medical costs, and this has remained constant over the past few decades
- Private insurers account for a growing share of total spending - 50% today, compared to 42% in the late 1980s
- Percentage of costs associated with inpatient care dropped from 64% to 27%
- The proportion of costs paid out-of-pocket by patients dropped from 17% to 8%
So despite all the publicity around the high cost of cancer drugs, this is not out of line with larger total medical expenditures. What is different is who is covering costs - private insurers are increasingly picking up the bill. Why are these findings different? What does this mean? The reason they are different than what we've been hearing lately is that this study is the first of its kind to combine cost data across payers. Notably, study is based on telephone interviews done in 1987 and from 2001 through 2005.
A few caveats to keep in mind. It is possible, that with the advent of a host of very expensive new targeted therapies, the data for the past 5 years might look different. Also, the study did not include diagnostics (such as imaging) which we know to be a huge cost driver.