ASCO shall examine the consequences of the health care reform on cancer care differences; Makes recommendations for gaps

To help address serious racial and economic disparities in cancer prevention, diagnosis and treatment in the United States, released the American Society of Clinical Oncology (ASCO) today released a policy statement that the specific provisions of 2010 patient protection outlines affordable law and care that have the potential to these inequalities. ASCO statement makes recommendations to ensure that such provisions are effectively implemented and urges additional steps to address systemic issues including insurance reform, quality of care, prevention, research, and diversity in the health care workers.

ASCO of Declaration, to be published in the Journal of Clinical Oncology, identifies specific measures to help eliminate cancer care differences including:

--Adoption of patient-centered quality improvement initiatives;

--Attracting more minority doctors and improving the training of the Oncology workforce to meet the needs of racist and ethnically diverse patients with cancer;

--Improving the collection of data about cancer disparities and determine what needs to be done to provide meaningful medical evaluations;

--Ensure access to cancer specialists for all patients receiving treatment at federal qualified district health centres;

--Allowing for cancer-centered in the direction of Oncology professionals in district health centres and medical homes where many find medical care services.

"The affordable Care Act offers a foundation for meaningful progress in eliminating disparities in health care," said ASCO President Michael p. Link, MD. "Many of its provisions, however, are vague and open to interpretation. In addition, requires substantial progress additional measures that are not in the new law. "

Main recommendations of ASCO policy statement

Improvement of the insurance coverage of the

By increasing Medicaid eligible, the affordable Care Act has the potential to increase the number of uninsured by 59 percent. However, his 23 million individuals estimated to be uninsured by 2019.

The oncologist Mary Shields, MD, who in the Maryland Eastern Shore practices, learned that the insurance coverage is one of the biggest factors accounting for differences in care first-hand. "When I first came from Philadelphia to practice here, I spoke with many uninsured patients and people in the Church and community meetings about the importance of cancer screening and prevention. When Maryland implemented screening programs, I began to see fewer patients with late stage cancers. Better access to screenings and follow-up testing of improved results for patients in my community, "said Dr. Shields.

But a major concern of ASCO is that evidence shows that with low fee, cancer patients on Medicaid fared no better than patients who have no health insurance.

In Brooklyn, N.Y., Gina Villani, MD, MPH, serves a limited income population is about 85 percent minority. Dr. Villanni said, "I worry about the care coordination and low Medicaid reimbursement rates that often force providers to neglect the underinsured."

ASCO is to ensure that Medicaid patients consistent access to quality cancer care, policy makers to ask:

--Offer Medicaid patients diagnosed with cancer with immediate, provisional eligible for Medicare

--Reimbursement of physicians that cancer patients on Medicaid Medicare rate.

In addition, separate from the affordable Care Act, ASCO and other medical societies are calling on Congress to ensure that Medicare payment a flawed formula known as the sustainable growth, to ensure that patients have access to quality cancer care have continued in the coming years.

Improving prevention and Screening Follow-up

Although health care reform legislation mandates that insurers cover certain cancer screenings, no expressly requires insurers to cover follow-up tests if an abnormality is found. For example, if a polyp is found during a colonoscopy, insurers are not legally obliged to follow-up diagnostic examinations and biopsies to cover. ASCO calls for Congress to require insurers to cover appropriate follow-up testing without patient copays or deductibles.

"Many of my patients cannot afford copayments of five dollars or less for life-saving medicines, so they certainly cannot afford to pay for follow-up medical testing," said Dr. Shields.

Meeting the needs of diverse patients

Provisions in the law directly to the Secretary of Health and Human Services (HHS) to support the development of curricula for cultural competence programs, and effective health plans in 2012, summary of benefits and appeal processes are expressly required to be presented in a culturally and linguistically sensitive manner. For example, summaries are written in clear language to be understood by those with limited English proficiency.

Dr. Villani said, "for many of our patients, the system can be overwhelming, especially when English is not the mother tongue. So did my hospital set changes to the facility more inviting and extra support to patients who help coordinate and navigate their care. "

Quality of care measures develop

The new law also authorizes the development of a strategy to develop and test measures for improving the quality of care as a means to reduce disparities in health care.

ASCO supports this measure, and has made significant progress on improving the quality of the care of cancer in the last ten years. ASCO launched its national programme for improvement of data-driven quality, the quality oncology practice initiative (QOPI) in ® 2006 after five years of research and development. QOPI is the first national programme to help improve the quality of care they deliver practices and certify outpatient Oncology offices to meet the highest national standards of cancer care delivery. Today, more than 700 practices.

Dr. Villani said that her hospital is interested in the pursuit of ASCO QOPI program. "Regardless of insurance coverage, patients deserve high quality of care. By highlighting areas where my practice can improve, we can work together to better care, "she said.

Dr. Link explained. "When it comes to bridging the differences, does quality. A meaningful quality initiative should be based on best practices derived from published clinical guidelines, measures and collective expert consensus. Care minus quality is much better than no care at all. "

Source: American Society of Clinical Oncology (ASCO)