Resource and Reimbursement Barriers to Comprehensive Cancer Care Delivery: An Analysis of Association of Community Cancer Centers Survey Data

Al Bowen Benson*, Leigh Boehmer, Xinlei Mi, Masha Kocherginsky, Latha Shivakumar, Julia R. Trosman, Christine B. Weldon, Ya Chen Tina Shih, Elizabeth A. Hahn, Sheetal M. Kircher

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

1 Scopus citations

Abstract

PURPOSE:Comprehensive cancer care (CCC) delivery is recommended in guidelines and considered essential for high-quality cancer management. Barriers, such as insufficient reimbursement, prevent consistent access to and delivery of CCC. Association of Community Cancer Centers conducted a national survey to elucidate capacity and barriers to CCC delivery to inform policy and value-based payment reform.METHODS:Survey methodology included item generation with expert review, iterative piloting, and cognitive validity testing. In the final instrument, 27 supportive oncology services were assessed for availability, reasons not offered, and coverage/reimbursement.RESULTS:204 of 704 member programs completed survey questions. Despite most services being reported as offered, a minority were funded through insurance reimbursement. The services least likely to obtain reimbursement were those that address practical and family/childcare needs (0.7%), caregiver support (1.5%), advanced care directives (1.7%), spiritual services (1.8%), and navigation (2.7%). These findings did not vary by region or practice type.CONCLUSION:There is a lack of sufficient reimbursement, staffing, and budget to provide CCC across the United States. Care models and reimbursement policies must include CCC services to optimize delivery of cancer care.

Original languageEnglish (US)
Pages (from-to)E428-E438
JournalJCO Oncology Practice
Volume19
Issue number3
DOIs
StatePublished - Mar 1 2023

ASJC Scopus subject areas

  • Health Policy
  • Oncology(nursing)
  • Oncology

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