Follow clinical evidence in cancer care

The current rise in healthcare spending in the United States is unsustainable. Any solution that aims to address this trend must address the cost and quality of cancer care.

Cancer is a devastating diagnosis. What’s more, cancer treatment is among the top three most costly conditions, and costs are rising faster than general medical costs.

Much of the rise in cancer care cost is attributed to better screening technologies, new medicines, improved surgery and advanced radiation therapy. Additionally, as baby boomers age, the rate of cancer increases since most cancers are diseases of aging.  Almost 1% of a typical working-age population and 5% of a Medicare-age population are diagnosed with cancer each year.

At Aetna, we are focused on creating sustainable new models of healthcare delivery that address costs while improving the member experience and health outcomes. While cancer survival in the United States is superior to that in most of the world, considering that the United States spends two-and-a-half times more than most developed nations in the world, shouldn’t it be better?

Better models for cancer care are possible to give patients convenient access to more effective cancer care with fewer side effects, less time in treatment, and lower costs. The following elements are critical:

• Expertise and technology that delivers evidence-based decision support and a payer-agnostic system that is scalable and easily accessible to providers;

• An enhanced patient experience that provides proactive support throughout treatment and helps keep the patient in charge of his or her care and, if necessary, end-of-life planning; and

• A sustainable payment model that supports and preserves the benefits of community oncology care such as convenient, personalized care.

Aetna has been working with the clinical community on varying approaches to identify and share the best treatment models. We have shown that following clinical evidence can get to equal or better outcomes at lower costs. But to use evidence on a broad scale, connectivity has to be a significant part of the solution.

Aetna has invested in Medicity, providers of health information exchange (HIE) technology solutions. Through Medicity, we can offer a platform for communication between hospitals, primary care physicians, specialists, payers and most importantly patients. We can also make evidence-based, decision support and reporting tools available through the HIE.

The information transfer facilitates real-time communication and is payer agnostic, which addresses one of the most glaring problems in today’s healthcare system: fragmentation. Multi-directional dialogue will be critical to the success of new delivery models that preserve community care, including patient-centered medical homes and accountable care organizations.

As a society, we must find better ways to make cancer care more effective, accessible and affordable. We must connect clinical evidence, dialogue, payment and patient support to improve outcomes and the patient experience.

Michael Kolodziej, MD, is the head of oncology strategy for Aetna.