This month, as part of the 20 Years Later series, we are revisiting the fourth principle of the Imperatives for Quality Cancer Care: Access, Advocacy, and Accountability.
The fourth principle in the Imperatives for Quality Cancer Care states, “All people diagnosed with cancer should have access to and coverage for services provided by a multidisciplinary team of care providers across the full continuum of care. Health care plans should be held accountable for timely referral to appropriate specialists when symptoms of cancer or its recurrence may be present.”
Anyone who has been diagnosed with cancer understands that there are multiple members of the care team who need to work together to care for the patient. And anyone who has waited for follow-up related to symptoms of cancer knows the agony of waiting for a diagnosis.
Cancer is a complex disease. People undergoing treatment for cancer have some combination of surgery, radiation, and chemotherapy or other medical treatment. In addition, they often see numerous specialists to address the symptoms and side effects of cancer, as well other medical conditions. Ideally, they have psychosocial support through their cancer treatment and beyond. Without coordination among these providers, patients can feel lost. Coordination of care across the full continuum, from diagnosis through treatment and survivorship or end-of-life care, continues to be a challenge for individuals facing cancer today.
In 2013, the Institute of Medicine released a report, Delivering High-Quality Cancer Care: Charting a Course for a System in Crisis. NCCS was one of the sponsors of the report, which was an update from a similar report on quality cancer care issued in 1999. Unfortunately, there has not been enough progress in providing patient-centered, evidence-based, coordinated care for people with cancer. The Institute of Medicine made a number of recommendations, including that members of the care team should coordinate with each other and with primary care physicians and specialists to implement patients’ care plans and deliver comprehensive, efficient, and patient-centered care.
There are many experiments with payment models that will incentivize the kind of coordinated care that patients need. NCCS has been a leading patient voice in the development of these models, and we will continue to advocate on behalf of patients, who deserve access to the best care.