Editor's note: This blog was originally published on May 23, 2022
While oncology leaders have spent the past two years responding to the immediate impacts of the pandemic, the peri-Covid-19 era has brought structural elements of the oncology landscape into flux. As such, the future direction of oncology is uncertain and can play out in directionally different ways. This creates a unique but time-limited opportunity for oncology leaders to influence the trajectory of the industry.
In our 2022 Oncology State of the Union (SOU) webinar, we described five key inflection points for which the future of oncology is still undecided and provided our take on the potential future scenarios. The webinar attendees, which included over 400 oncology leaders from around the country, then reported which future scenarios they predict will come to fruition for each inflection point.
Here are the five key strategic questions about the future of oncology and how oncology leaders think they will be answered:
1. Will we achieve value-based care at scale in oncology?
Given the imminent end of the Oncology Care Model, the indefinite delay of the Radiation Oncology Model, and mixed results from commercial payers' alternative payment models, the future of value-based care in oncology is anything but certain.
Recent changes commercial health plans have made to their payment models and other value-based care initiatives can give us an indication of where the industry is headed. However, the shape and success of value-based care in oncology moving forward will depend largely on the level of stakeholder participation in and alignment around value-based care initiatives and provider willingness to engage in risk-based contracting.
When we asked oncology leaders about the future of value-based care in oncology, 62% of the 175 respondents responded that selective participation in value-based care initiatives will limit the impact and scale of value-based care in oncology over the next five to 10 years.
This is not what we consider to be the ideal scenario, as cross-industry commitment to advancing value-based care in oncology will be needed to decrease the total cost of cancer care and ensure all patients receive efficient and evidence-based care. We urge oncology leaders to acknowledge their role in creating this future scenario, because only their actions can determine which scenario becomes a reality.
2. Will we reduce national cancer drug spend?
While health plans have been sounding the alarm on the rapid growth in cancer drug expenditures for a while now, we've recently begun to see the government, providers, and manufacturers take a greater interest in mitigating drug spending as well. The new strategies they're experimenting with have the potential to reduce rising drug spend, but only if oncology leaders are truly bought in on prioritizing efforts to lower cancer drug spending and willing to coordinate with others across the industry.
Unfortunately, cancer leaders think the unsustainable growth in national cancer drug spending will continue. In fact, when asked during the webinar, 70% of 168 respondents indicated that this less preferable scenario is most likely. However, oncology leaders can take action to change the likelihood of this future.
3. Will site of care be personalized for each cancer patient?
Cancer care services are increasingly shifting from the hospital setting to other sites of care due to pressure from payers, the impact of the pandemic, new technologies, and other factors.
However, these shifts are not without challenges. Oncology leaders today will have significant influence over whether care shifts continue at the same pace we've been seeing and how patient-centered cancer care is across those sites of care in the future.
When we asked oncology leaders what they expect to see, only a small percentage (13%) predicted that site-of-care shifts will slow. Fortunately, 50% of the 119 respondents thought the site-of-care shifts will continue with a patient-centered focus over the next couple of years.
This is the preferable scenario, and it is certainly a hopeful sign that so many oncology leaders believe this patient-centered shift is possible. Ideally, this perspective will allow oncology leaders to confidently invest in patient-centered site-of-care shifts.
4. Will all employers compete equally for employees?
The oncology leaders we've talked to recently are feeling the strain of staffing shortages, high turnover rates, and changing employee preferences and expectations in the wake of the pandemic. Traditional oncology providers, such as hospitals, health systems, and independent physician practices, are seeing growing competition from non-traditional provider organizations, including investor-backed provider networks, health plan-owned medical groups, and staffing agencies. Non-provider organizations (e.g., digital health companies, pharmaceutical and medical device companies, regulatory agencies) are also increasingly competing to hire oncology employees.
With growing competition from these non-traditional players in the oncology space, the actions that traditional oncology providers take now to adapt their employee value propositions will affect where oncology employees choose to work and providers' ability to meet patient demand and maintain market share.
In the ideal scenario, traditional oncology providers would adjust their value propositions so that all oncology employers can compete for employees on an equal playing field. However, when we polled oncology leaders, 81% of the 116 respondents projected that traditional oncology providers will continue to struggle to compete for employees and will therefore experience the workforce challenges associated with the inability to recruit and retain employees.
Although this is usually an issue that oncology leaders view as a concern and responsibility of the human resources department, it’s extremely important that oncology leaders recognize the power that their decisions might have in creating a stronger oncology workforce.
5. Will health equity become a business imperative?
The Covid-19 pandemic brought discussions of health equity to the forefront, and we've seen many cancer programs and other industry organizations create initiatives to reduce health disparities and promote access to care.
However, two years into the pandemic, these efforts are at risk of losing momentum as oncology leaders' attention is pulled in other directions. Whether efforts to promote health equity remain siloed and one-off or are elevated to become a critical business imperative for oncology organizations will depend on the strategy set today by oncology leaders. Ideally, oncology leaders would make health equity a critical business imperative for their organizations, with widespread recognition that addressing disparities in cancer care can have major positive business incentives – not just moral and ethical incentives.
When we surveyed oncology leaders during the 2022 Oncology SOU webinar, just over 80% of the 91 respondents thought that health equity will become a strategic business imperative for oncology organizations. The fact that so many oncology leaders responded this way is very promising for the future of health equity in oncology.
Collaborative action from oncology leaders across the health care industry, including leaders from provider organizations, health plans, regulators, life sciences companies, and digital health companies, will be required to influence the direction of oncology across these five inflection points.
Consider taking the time to view the recorded 2022 Oncology State of the Union to gain a deeper understanding of the current state of oncology and what you can do to shape its future.