Cancer Centers Struggle With Cost, Complexity of Measuring Quality

Most community cancer centers are only beginning to measure quality of care and are struggling with the challenge of collecting data while adding services and keeping costs in check, concluded a recent survey by the Association of Community Cancer Centers (ACCC).

“Demonstrating quality in the delivery of cancer care is challenging, complex, and resource intensive,” according to “Trends in Community Cancer Centers,” the ACCC’s fourth annual membership survey. “Although quality is a metric that the vast majority of cancer programs are interested in measuring, they see this goal as a difficult journey in which they are only in the initial stages.”

Cancer programs reported using a variety of tools to measure quality, the report said, including the Commission on Cancer standards (94%), patient satisfaction scores (91%), the Quality Oncology Practice Initiative (36%), and the Physician Quality Reporting System (34%). Only 5% said they participated in an Accountable Care Organization, although about half plan to participate eventually through their hospital (two-thirds of respondents were hospital-based or university-affiliated cancer programs).

Many centers introduced new services as they prepared to comply with the new Commission on Cancer Standards that becomes effective in 2015, the survey said.

“More cancer programs are investing in patient navigation services, cancer survivorship services, and genetic counseling,” said ACCC President Virginia T. Vaitones, MSW, OSW-C in a news release. “Cancer programs are working to ensure patient access to quality care while balancing efforts to control costs, measure quality, and implement new standards.”

Other key findings of the survey included:

• Just over 90% of respondents said they would be interested in joining a professional peer network in order to share best practices related to measuring quality of cancer care delivery in hospitals.

• Most respondents said they struggled to cut costs without reducing services or staff over the previous financial year (2011). The most common cost-containment strategies cited were reducing travel and conferences, renegotiating vendor contracts, cutting administration, and delaying capital expenditures.

• To boost revenue, 61% of centers reported adopting new technologies and service lines, a 10% increase over the previous year’s survey.

• The number of uninsured patients or those who had difficulty paying for treatment and copayments remained high, although there was a small improvement over the previous year. Over the past 12 months, 88% of survey respondents reported seeing more patients who needed help paying for their prescription drugs and three-quarters of respondents reported an increase in the number of patients who needed help with transportation expenses.