Reimbursement Challenges Persist as Oncologists Embrace Value-Based Care, ACCC Survey Finds

Among other challenges faced by cancer care centers, reimbursement for providing patient-centered care services remains at the top, a survey by The Association of Community Cancer Centers found.

The Association of Community Cancer Centers (ACCC) recently released the findings of its survey on Trends in Cancer Programs, which saw majority participation by hospital-based outpatient cancer programs. Of the several challenges that oncologists said they face, lack of reimbursement for supportive care services headed the list (65%), followed by budgetary restrictions (61%). Close behind were lack of space, marketplace competition, ability to meet multiple accreditation requirements, drug costs, and financial challenges faced by patients.

While oncology care centers have increasingly been providing patient-centered services—nurse navigators, survivorship care, palliative care, and psychological counseling—the survey indicates that they do not receive adequate compensation for those services. “America’s cancer programs are increasingly being asked to do more with less, a trend we are seeing across healthcare,” said ACCC president Steven L. D’Amato, BSPharm, BCOP, in an associated press release, emphasizing the need for payers to realize the value of the patient-centered care offered by cancer centers.

The survey found that more than 50% of the surveyed cancer programs are implementing quality and compliance initiatives to improve patient adherence. These efforts include patient outreach and education, tracking refills, tracking new prescription fill, and reaching out to non-compliant patients. Quality metrics in various forms are also being used, albeit in various forms:

  • Commission on Cancer (CoC) standards (94%)
  • Patient satisfaction scores (90%)
  • Quality Oncology Practice Initiatives (54%)
  • In-house guidelines (48%)
  • Physician Quality Reporting System (43%).

These are then communicated to payers as a value-add to the cancer care services using the following metrics:

  • American College of Surgeons CoC accreditation (87%)
  • The Joint Commission accreditation (74%)
  • Press Ganey scores (57%)
  • Reporting data on quality improvement initiatives (52%)
  • National Accreditation Program for Breast Centers accreditation (51%)
  • Benchmarking patient outcomes against other programs (51%).

“Reporting this information is one of the best ways that programs can show the value of the services they provide, especially new services designed to better meet patient needs across the spectrum of care, and we encourage programs to continue to take this important step,” said D’Amato.