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IOM: Cancer Care System in Crisis

Cheryl Clark, for HealthLeaders Media, September 11, 2013

Provider Competency
Another issue threaded through the document pertains to the competency of care providers. There are accreditation programs, such as those run by the American College of Surgeons, and coping certification programs run by the American Society for Clinical Oncology.

"But what we're also talking about is health systems making sure that if there are nurses or aides on a ward taking care of cancer patients, that they know something about cancer. It's actually digging deep into the delivery system, and not just giving a professional accreditation for an organization."

The report lists 10 recommendations, each one followed by initiatives or actions that federal and other organizations should take to implement them.

Patient Engagement
1. The cancer care team should provide patients and their families with understandable information on cancer prognosis, treatment benefits and harms, palliative care, psychosocial support, and estimates of the total and out-of-pocket costs of cancer care.

The report says the National Cancer Institute, Centers for Medicare & Medicaid Services and other public and private stakeholders should develop decision aids and make them available, and CMS should "design, implement and evaluate innovative payment models that incentivize the cancer care team to discuss this information with their patients."

2. In a setting of advanced cancer, the cancer care team should provide patients with end-of-life care consistent with their needs, values, and preferences.

To do this, the report says CMS should have payment models that incentivize cancer teams "to counsel their patients about advance care planning and timely referral to hospice care."

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