Payers Can Help Survivors Thrive After Treatment: Bhavana Bhatnagar, DO

Cancer survivors are living longer, but longer survival brings a new pressing question: who helps them live well afterward? For Bhavana Bhatnagar, DO, West Virginia University Cancer Institute at Wheeling Hospital, the answer depends partly on how payers choose to direct their resources. Asked which payer lever could improve patient care the fastest, Bhatnagar pointed to resources aimed at equity and social determinants of health.

She noted that she cannot currently offer chimeric antigen receptor (CAR) T-cell therapy where she works, so interested patients must travel to a center that can. Payer support for transportation, housing, and caregiver needs, along with funding to offset the cost of expensive novel medications, would help make access possible, she said. A close second, she said, is support for a registry that would help identify gaps in care between major academic medical centers and local community hospitals, so patients are not disadvantaged by where they receive treatment.

Bhatnagar also described the growing challenge of survivorship. Some survivors live with lasting physical adverse effects, while others struggle with the emotional and psychological toll of treatment—and each person’s needs differ. She said visits with patients who have completed chemotherapy are often her longest, even though the conversation centers on life after cancer rather than the disease itself. Because she is not trained in survivorship care, she does not always have good answers for where to refer them. As treatments improve and people live longer, she expects the issue to grow.

Financial toxicity compounds the burden, Bhatnagar said, particularly for younger patients who may not be working or are early in their careers. She also called for policies that support intentional survivorship care, including coverage for financial and psychological support programs. Ultimately, Bhatnagar wants patients not only to survive but thrive, so that “they’re able to live their life in a meaningful way and that cancer didn’t just sort of put everything to a halt,” she said.