Innovations in oncology and the treatment of cancer care are complex, topping an estimated $200 billion in 2020. As cancer research constantly develops new treatments and data, payers and providers are learning valuable lessons on improving the delivery of care. Cancer care involves orchestrating a strong support system and building a meaningful and collaborative relationship between all parties involved: provider, payer and patient.
It is always difficult to go from diagnosis to treatment. The patient and family are faced with absorbing a serious diagnosis while having to approve a course of treatment to follow. Treatments must be applicable and accessible to all, scaled to align with best practice and consistent, values-based care, and always based on the best available science.
With rising costs, data enable effective strategies and reduce oncology Treatment expenses
Treating cancer patients has a huge impact on the entire healthcare economic ecosystem due to the costs associated with treatment. Health care spending related to oncology is expected to reach $246 billion by 2030, swelling as baby boomers age and receive more cancer diagnoses. And even without the boomer effect, data suggests that in the United States, between $75 billion and $101 billion is wasted each year on overtreatment or low-value cancer treatments.
Additionally, a recent study published by JAMA Internal Medicine found that over a six-month period, US hospitals increased the price of cancer treatments for patients with private health insurance, in some cases more than seven times. As costs rise, early interventions, diagnostic accuracy and evidence-based treatment are essential to optimize outcomes and contain the costs that continue to soar.
While it is important to seek cost-cutting measures, patients, providers and payers cannot compromise on their expectations of comprehensive, evidence-based advice for the treatment of complex conditions. Today, leveraging cutting-edge technology to decipher treatment options – or validate approaches – offers providers and payers another resource to complete their missions faster, more accurately and more efficiently, creating savings across the continuum.
One way to support this is to use an advanced research library platform that enables cancer treatment authorization and ensures the prescription of high-quality, high-value care that quickly aligns treatment with providers and payers. . Today, increasingly sophisticated, evidence-based treatment validation and decision support platforms can rapidly connect providers and payers to treatments and protocols that rapidly deliver high-quality, effective care. value and provide peace of mind at the time of prescription.
In some cases, clinicians can review thousands of evidence-based treatment regimens, federally registered clinical trials, levels of evidence, expected clinical outcomes, and treatment costs before selecting a treatment for their patients. Most importantly, these tools align the interests of all parties involved before treatment begins, leading to value-based care and avoiding patient bottlenecks and wasted valuable time.
Create consistency in care
A shared hub of information and factual data also enables new levels of consistency. Today, the treatment of a cancer patient is too often determined by the circumstances of their diagnosis as opposed to one-size-fits-all decision-making with evidence-based data and outcomes. Within the same extended practice, it is not uncommon to encounter different treatment approaches. With the number of insights and the ever-increasing tide of new data involved in cancer research and treatment, no single vendor might be able to decipher all the paths.
Providers can eliminate unnecessary variability in care by applying nationally accepted standards of treatment when clinically prescribing. Second, the automated process reduces the administrative burden of obtaining and providing authorizations and ensures appropriate reimbursement at the plan level, aligning payers and physicians in the best interests of patients while limiting appeals and denials. .
Choosing the most effective and value-based treatment is also everyone’s goal when treating cancer. This is the first and most important step forward, and the treatment discussion can lay the groundwork for therapeutic collaboration. If done correctly, discussing treatment with patients starts an ongoing conversation in which all participants get along, understand and trust each other.
Access to data and shared decision-making is an organizing principle known to inform patients, increase decision satisfaction, and improve patient-physician communication. When the patient grasps the arguments for and against treatment and understands that they can choose, questions are asked aloud, trade-offs are explored, and conversations, not medical conferences, take place.
The value proposition
Clinical decision support and treatment validation platforms automate the transfer of health plan and patient clinical data and care information, benefiting all stakeholders in the healthcare ecosystem and having the ability to dramatically increase the consistency of care.
Health care plans can move from organizations traditionally viewed as gatekeepers to active participants in improving the quality of care. In addition to dramatically increasing process efficiencies, healthcare plans can implement technologies that enable the authorization of appropriate, evidence-based care for the patient, which in turn manages costs while generating positive results.
For doctors and caregivers
Providers can use the clinical knowledge they have about the patient to review optimal treatment options based on scientific evidence and aligned with payer policies, helping them to make informed care decisions with the patient.
When health care plans and providers align themselves with high-quality, high-value care, patients enjoy peace of mind that their care plan meets both evidence-based standards and repayment requirements.
Reduced costs and errors
In the United States, the average cost of unwarranted care per patient is $25,579. Ensuring that the most appropriate treatment is prescribed for each patient from the outset can reduce unnecessary expenses for unnecessary and inappropriate care.
The goal is to increase the quality of care, focus on preventative maintenance, and promote healthy choices to reduce long-term health care costs. Healthcare providers can simplify their patient care by analyzing historical data and eliminating unnecessary tests and procedures. Educating patients about the potential pitfalls of treatment can quickly pay off: eliminating just one night of hospitalization in a patient’s lifetime can result in significant cost savings while reducing patient stress.
Prevention of medical errors, scenarios that every provider and their patients want to avoid. More importantly, improves results. Healthcare providers and insurers allocate significant resources to identify, understand and reduce medical errors. Standard procedures and checklists can reduce oversights leading to errors. Improved platforms and programs can provide timely information to prevent medical errors and reward healthcare providers who reduce them. Quality and outcomes of care improve while costs decrease.
Improving cancer patient outcomes requires multifactorial approaches across the continuum of care. However, it will never be enough for researchers to advance treatments and bring new drugs or procedures to market. There must also be evolutionary continuity and accessibility to evidence-based approaches. Additionally, factors such as expediting diagnosis and treatment, getting to patients quickly with evidence-based treatments, and the ability to reassess as conditions change are all important to advancing outcomes.
Consistent, evidence-based care aligns payers, providers, and patient outcomes. Early diagnosis and personalized treatment lead to better outcomes, and technology has a central role to play for every patient.
 Financial burden of cancer care. Trends in American Cancer Control Measures. National Cancer Institute. In line. Last accessed May 10, 2022.
 The cost of cancer, 2020 edition. Cancer Action Network. In line. Last accessed May 10, 2022.
 Shrank WH, Rogstad TL, Parekh N. Waste in the US healthcare system: Estimated costs and savings potential. JAMA. 2019;322(15):1501–1509. doi:10.1001/jama.2019.13978 Online. Last accessed May 10, 2022.
 Xiao R, Ross JS, Gross CP, et al. Price of cancer therapy administered by the hospital for patients with private health insurance. Intern JAMA Med. Published online April 18, 2022. doi:10.1001/jamainternmed.2022.1022. In line. Last accessed May 10, 2022.
 Treatment validation options for hospitals and healthcare systems. NantHealth. In line. last accessed May 10, 2022.
 Study identifies billions of dollars in potential savings by eliminating unwarranted, non-evidence-based cancer treatments. BusinessWire. In line. Last access on May 10, 2022.
Featured image: binary code, data stream. Photo credit: © 2016 – 2022 Fotolia/Adobe. Used with permission.