Providing Timely Cancer Care Access Is Crucial Amid Growing Patient Volume

Devon Womack

The cancer care landscape is experiencing dynamic forces impacting providers’ ability to meet growing demand for patient care services. Cancer risk increases with age, so cancer cases will continue to rise in the United States, driven by an aging population.¹ An estimated 18 million individuals in the United States with a history of cancer were still alive on January 1, 2022,² and many require follow-up care, putting even more pressure on providers.

Beyond the growing number of patients requiring care, there is a looming shortage of oncologists. According to the American Society of Clinical Oncology (ASCO), there were 12,940 oncologists in the US workforce in 2020.³ Unfortunately, almost 20% were nearing retirement age, and only 15.6% were early career oncologists younger than 40 years.⁴

Oncology practices must develop innovative strategies to optimize their services to meet increasing demand. A closer look at some of the approaches being used across The US Oncology Network (The Network—a network of independent, physician-owned community-based practices—to improve patient access can provide helpful insight into how practices can meet the growing need for their services.

The Anxiety of Prolonged Waiting Times for Patients

There are important reasons why new patients with cancer should be seen quickly. Most have a long wait before arriving on the oncologist’s doorstep, given the journey from a referring physician to an oncologist and the additional time that may have been spent undergoing screening. During that time, anxiety builds in patients over whether they really have cancer and, if so, what the path forward looks like.

Certain cancers progress quickly, so seeing patients as soon as possible is critical. The priorities at this stage are to care for patients by reducing their anxieties and by promptly creating a treatment plan that moves their care forward.

Maximizing the Care Team to Support Increased Volume

Given the declining number of oncologists and the increasing demand for services, practices must find effective ways to offset some of the work oncologists handle, and identify strategies to optimize existing patient services. This will enable more patients to be seen in a timely manner. Here are a few approaches being used across The Network to enhance patient access:

Integrate advanced practice providers (APPs) into the care model. Effectively using APPs maximizes oncologists’ time, enabling them to see more new patients. Consequently, there is a growing trend to form care teams with APPs. With this model, oncologists oversee new patients or acute changes in therapy, whereas APPs perform follow-ups, help with initial intake, and manage less severe cancer types and patients having repeat infusions. For instance, practices often receive referrals for those with hematological and benign conditions. These individuals can receive a high level of care from the care team and an APP, as opposed to an oncologist. APPs can also support palliative care conversations.

Incorporating oncology-focused pharmacists. The number of oral products in cancer care is growing rapidly. From 2019 to 2021, the FDA approved 44 new cancer therapies, of which 27, or 61%, were oral anticancer agents.⁵ Oncology-focused pharmacists can play an important role in managing care for patients on oral therapies. With pharmacists monitoring dosing and collaborating with oncologists, more oncologists’ time can be freed for other tasks that only they can perform.

Leveraging telehealth technologies. Based on a 2020 report by the US Census Bureau, the rural population represents 20% of the nation’s total population,⁶ and according to an ASCO report, 66% of rural counties have no oncologist.⁷ This disparity creates a significant challenge in ensuring individuals in rural communities can get the care they need.

Telehealth, which grew tremendously during the COVID-19 pandemic, provides a viable solution for delivering a wide range of cancer care services to rural dwellers who face obstacles in gaining access to care. Many practices have focused on telehealth and become very competent in its use. The technology is especially suited for follow-ups, long-term monitoring, and survivorship care. It also saves significant time for patients and providers. A recent study found telehealth visits saved patients an average of 2.9 hours of driving time (round trip) and 1.2 hours of in-clinic time per visit,⁸ some of which may be freed for the care team to perform other tasks.

Provide patients access to financial counselors. Cancer care is expensive, and unfortunately, many health insurers and employers are moving into high-deductible health plans that can create severe financial burden for patients. Many practices are investing in financial counselors to help patients understand early in their cancer journey what their out-of-pocket expenses are and what resources they can utilize to help cover costs. There are several different funds for patients, and counselors can help them maximize opportunities for assistance, lowering the financial burden they face. This assistance enables patients to access care they otherwise might not be able to afford, as patients facing financial difficulties sometimes forego treatment altogether.

Strategies to Meet Growing Demand

The Network, supported by McKesson, is providing practices expertise, data, and innovative tools to advance their efforts to meet the increasing need for their services. By examining what is happening across The Network in large cities and small rural areas, best methods and valuable data are being compiled and shared to help practices better understand who is referring to them, how long it takes new patients to be seen, and ways to solve patient access challenges.

Following are a few useful strategies being employed and shared across practices in The Network:

• Care teams are building centralized contact centers to provide the best possible patient experience across all locations, from the patient’s initial contact until treatment ends.
• Practices are being educated on new technologies and customer care methods for contact centers to ensure patients have the best possible interaction, via phone or text messaging.
• The digital experience is being enhanced so patients can utilize portals to securely submit forms, pay bills, and communicate with their care team. Best practices are also being shared, providing ways to leverage APPs so they can communicate with patients online.
• Integrating precision medicine data into the physician’s electronic health record to quickly determine the best personalized treatment plan and potential clinical trial opportunities optimizes the practice workflow and, most importantly, provides the patient with timely access to the best treatments, close to home.

A team has also been created within The Network to visit and assess practices to identify specific issues that inhibit timely access to care. The team examines workflow issues, such as scheduling, new patient intake, lab processes, and other key functions. The focus is on developing improvements that enable new patients to be seen within 48 hours.

Timely Access: a Vital Part of the Mission

The US Oncology Network is composed of independent community oncologists and care teams dedicated to delivering high-quality care that provides the best outcomes for patients, close to home. They take great pride in offering patients innovative treatments and superior care in their local communities. A critical part of this mission is ensuring that patients who are referred to a practice are seen quickly, so they receive care as soon as possible during a difficult time. The Network is committed to supporting practices in their efforts to achieve this important goal, empowering them with the resources and tools necessary to provide patients timely access to the services they need.

Devon Womack is the SVP and COO of The US Oncology Network.

References

1. Age and cancer risk. National Cancer Institute. March 5, 2021. Accessed online August 24, 2023. https://www.cancer.gov/about-cancer/causes-prevention/risk/age
2. American Cancer Society. Cancer Treatment & Survivorship Facts & Figures 2022-2024. 2022. Accessed online August 24, 2023. https://www.cancer.org/content/dam/cancer-org/research/cancer-facts-and-statistics/cancer-treatment-and-survivorship-facts-and-figures/2022-cancertreatment-and-survivorship-fandf-acs.pdf
3. Physician Compare Datasets. Centers for Medicare & Medicaid Services. Accessed August 24, 2023. https://old-prod.asco.org/sites/new-www.asco.org/files/content-files/practice-and-guidelines/documents/2020-workforce-information-system.pdf
4. AMA Physician Masterfile. American Medical Association. Updated July 3, 2023. Accessed August 24, 2023. https://www.ama-assn.org/practice-management/masterfile/ama-physician-masterfile
5. Blinder VS, Garrett-Mayer E, Jacobsen PB, et al. Oral chemotherapy metric performance in quality oncology practice initiative practices: updated trends and analysis. J Natl Compr Canc Netw. 2022;20(10):1099-1106.e2 doi:10.6004/jnccn.2022.7024
6. Nation’s urban and rural populations shift following 2020 census. News release. United States Census Bureau. December 29, 2022. Accessed August 28, 2023. https://www.census.gov/newsroom/press-releases/2022/urban-rural-populations.html
7. Torres L. Health challenges facing minority communities. US Department of Veterans Affairs. April 21, 2023. Accessed August 28, 2023. https://news.va.gov/118294/health-challenges-facingminority-communities/
8. Winstead E. Telehealth can save people with cancer time, travel, and money. National Cancer Institute. February 16, 2023. Accessed September 8, 2023. https://www.cancer.gov/news-events/cancer-currents-blog/2023/telehealth-cancer-care-saves-time-money#:~:text=Estimated%20Savings%20in%20Context&text=At%20Moffitt%20Cancer%20Center,%20the,of%20time%20in%20the%20clinic