Across the summer of 2018, we partnered with the Association of Community Cancer Centers (ACCC) to conduct our second annual Trending Now in Cancer Care survey. The goal: Understand cancer providers' top challenges and how their priorities have changed across the past year.

Download the full national data report and read our initial insights below.

Download National Survey Results

Cost of drugs still top threat to growth

Similar to our 2017 survey, respondents most commonly ranked the cost of drugs as one of the top five threats to their future cancer program growth. This was followed closely by reimbursement requirements from payers. Rounding out the top five were uncertainties in drug pricing reform policies (note: this was even before CMS's recent proposal), workforce planning, and marketplace competition.

Which of the following are the biggest threats to future cancer program growth at your organization?¹
Percentage of respondents that ranked threat in top five, 2018
n=177

_{1) Respondents were asked to rank up to five threats.
2) For example, prior authorization or first-fill restrictions for in-office dispensary pharmacies.
3) For example, 340B or changes to Medicare Part B drug pricing.
4) For example, new LINACs or support for CAR T-cell therapy.}

Notably, marketplace competition and workforce planning ranked higher on the list of growth threats this year compared to last year.

Symptom management and clinical standardization top opportunities for cost savings

As cancer programs prepare for value-based care, it is critical to maximize every opportunity for cost savings. When we asked respondents what their biggest opportunities to cut costs are, more than half selected symptom management, reflecting the growing awareness about the costs of unnecessary ED and hospital visits, and clinical standardization. About 40% of respondents ranked drugs and care coordination.

Which of the following are your cancer program’s biggest opportunities for cost savings?¹
Percentage of respondents who ranked opportunity in top three, 2018
n=160

_{1) Respondents were asked to rank up to three opportunities or investments.
2) For example, financial counselor, billing and coding specialist, schedulers.}

Care coordination and symptom management also most commonly thought to deliver ROI

On the flip side, when it comes to driving ROI, respondents selected care coordination and increasing the number of subspecialists as two of the three investments most likely to yield a return for their cancer program. And more than one-third of respondents also flagged symptom management. Interestingly, screening services rose in ranking this year, while marketing and specialty pharmacy fell significantly compared to last year.

Which of the following investments do you believe are most likely to yield a return for your cancer program?¹
Percentage of respondents who ranked investment in top three, 2018
n=159

_{1) Respondents were asked to rank up to three opportunities or investments.
2) For example, breast surgeons, gynecologic oncologists.
3) For example, mobile screening unit, incidental lung nodule clinic.}

Oncology systems continue to grow

Many respondents are continuing to be involved in M&A transactions. 41% reported that their cancer program partnered with another in the past 12 months—the majority of which involved partnerships with existing hospitals or health systems.

Which of the following actions has your cancer program or practice taken in the past 12 months?¹
Percentage of respondents, 2018
n=181

What type of group has your cancer program or practice decided to partner with?^{1, 2}
Percentage of respondents, 2018
n=73

_{1) Respondents were asked to select all that apply.
2) Respondents were only asked this question if they indicated that they formed a partnership with another group in the past 12 months.}

Growth and physician alignment driving continued M&A

When asked why they partnered with another provider, the most common answer by far was to maintain or grow market share. Over 40% of respondents also indicated that physician alignment was a top reason for partnership. And one-third partnered to improve patient access. Almost all respondents are satisfied or very satisfied (97%) with their partnership.

What were the top reasons for deciding to partner with another hospital, medical group, or practice?^{1, 2}
Percentage of respondents that ranked reason in top three, 2018
n=64

How satisfied has your organization been with this merger, acquisition, affiliation, PSA, or co-management agreement?²
Percentage of respondents, 2018
n=62

_{1) Respondents were asked to rank up to three reasons.
2) Respondents were only asked this question if they indicated that they formed a partnership with another group in the past 12 months.}

Stay tuned for more findings on accreditation and quality, technology and IT, staffing, support services, barriers to care, and treatment from our 2018 Trending Now in Cancer Care survey. In the meantime, check out our insights from the 2017 survey.