Currently Viewing:
NCCN 22nd Annual Conference
Dr Moon S. Chen Jr Explains the Far-Reaching Benefits of the California Cancer Registry
June 06, 2017
Dr Matthew Gubens Outlines Exciting Directions for Lung Cancer Immunotherapy Research
May 20, 2017
Dr Moon S. Chen Jr on the Attitudes Needed to Design Population Health Interventions
May 13, 2017
Dr Shauntice Allen Discusses Community Engagement in Public Health Research
April 28, 2017
Dr Shaji Kumar Discusses Biological Foundations of New Multiple Myeloma Research
April 24, 2017
Dr Matthew Gubens: Multidisciplinary Approach Can Help Oncologists Tackle Immunotherapy Toxicities
April 21, 2017
Dr Moon S. Chen Jr: Culture and Behavior as Population Determinants of Cancer Outcomes
April 16, 2017
Helping Cancer Patients Quit Smoking Through Counseling and Pharmacotherapy
March 26, 2017
Dr Shauntice Allen Explains Community-Level Factors Contributing to Cancer Disparities
March 25, 2017
Dr Shaji Kumar: Advances and Opportunities in Treating Multiple Myeloma
March 25, 2017
Personalized Care in Lung Cancer Is All About the Molecular Subtype
March 24, 2017
Radiation Therapy Updates for Breast Cancer in the NCCN Guidelines
March 24, 2017
Dr Matthew Gubens Highlights Immunotherapy Advances and Combinations for Lung Cancer
March 23, 2017
Dr Moon S. Chen Jr Discusses Strategies for Reducing Cancer Disparities in Asian Americans
March 23, 2017
Multigene Panels Important for Precision Cancer Care, Variance and Coverage Barriers Remain
March 23, 2017
Currently Reading
Addressing the Roots of Disparities in Cancer Care: Inherent Bias, Resources, and Insurance
March 23, 2017

Addressing the Roots of Disparities in Cancer Care: Inherent Bias, Resources, and Insurance

Surabhi Dangi-Garimella, PhD
At the 22nd Annual Conference of the National Comprehensive Cancer Network, held March 23-25, 2017, in Orlando, FL, policy researchers with interest in cancer care disparities discussed the source of existing disparities and how they can be successfully addressed.
Filipic said that the Affordable Care Act (ACA) tried to address these disparities. “Since ACA was passed in 2010, over 22 million gained health coverage with the available provisions. The uninsurance rate nearly halved from 2014 (about 16%) to 2016 (under 9%). Across all demographic groups, a reduction in the uninsured rate has been seen.

“Congress will be voting on the AHCA [American Health Care Act] later today,” Filipic said. When questioned about her own leaning for the ACA, she said, “While I have bias, many cancer societies have expressed concerns about the AHCA. The Congressional Budget Office, which is a non-partisan institution, has projected that 14 million would lose coverage by 2018. Cost is king…whether it is Medicaid expansion or the tax credits that bring affordable coverage within reach. So ultimately, we are seeing that lower income and sicker individuals stand to lose in this proposal.”

“Disparities are already hard to manage, and with 14 million losing coverage will have an interesting effect on the population,” said Allen.

Nassi emphasized the importance of reaching out to community clinics that often work under constrained resources. “Those of us working within cancer systems, we forget that providers in clinics or in the community do not have the same resources. Doctors tell us ‘If we don’t treat it, we don’t look for it.’ So sometimes the bias is inherent because of financial situations.”

“One potential area of bias is who gets recruited in clinical trials. So if a provider cannot speak the patient’s language, he may not spend the time to explain the advantages of participating in a trial or the assumption that the patient may not want to participate,” Chen said.

Tapping into her years of experience as an oncologist, Mitchell said the zip code is a good identifier of disparities. “So one of the things we need to do is give individualized medicine that is not based on where they live but what their medical status is,” she said.

Nassi explained that at Hunstman, “We are doing outreach, pushing screening, trying to educate. But the resources do not exist in the communities. Cancer centers, on the other hand, do have the resources…so we need to go to them with the resources.” She explained, however, that there need to be a plan in place after a person is diagnosed, because treating 1 individual with cancer in the American Indian community can wipe out the budget for the community.

Filipic explained that the perception of affordability is also a bias. She shared an example of a woman from a focus group conducted by Enroll America, who did not have any knowledge on the healthcare coverage options she had available on the ACA because she assumed she would not be able to afford the premium. “Many do not understand that there is affordable insurance and there are tax credits available,” she said.

“I have been a big proponent of the healthcare institution understanding the patient population—who they are and getting their community involved,” Mitchell explained. “For example, mammograms may not be covered by an individual’s insurance plan, but there may be community programs that provide free mammograms.” She added that her institution has made it more convenient for patients receiving cancer treatment to receive their care without having to forego their work hours or income, with extended chemotherapy care on weekends and walk-in clinics with more flexible hours.

“Cancer centers need to accept this challenge of addressing disparities. Once you make the commitment, and look beyond collecting data and getting the grant, we must go to the community and see what can be done there,” said Nassi.

Copyright AJMC 2006-2018 Clinical Care Targeted Communications Group, LLC. All Rights Reserved.
Welcome the the new and improved, the premier managed market network. Tell us about yourself so that we can serve you better.
Sign Up

Sign In

Not a member? Sign up now!