A call for action: leadership is needed now on quality, safety, and pay for performance in community oncology

Abstract

An action plan is in place; the time to get involved is now. ���������� O ver the past 20 years, community oncologists have been quietly elevating the quality of cancer care across the country, broadening access and improving affordability in large cities and towns and in small rural communities. Our work with more than 80% of American cancer patients and 60% of the patients taking part in clinical trials has resulted in signifi cant improvements in survival rates, lengthened times to disease progression, improved quality of life, and improved end-of-life care. This success has received little fanfare as small groups of cancer professionals have dealt with the cancer burden and met local cultural needs. But we now need to discuss this success more vigorously in order to educate the many healthcare stakeholders about the value of our accomplishments. Only in this way can we preserve community cancer care and ensure its continued evolution to meet increasing demands, even as we remain high touch and high tech. Newer treatments, an aging population, cancer patients living longer—all of these factors have increased the costs of cancer care. Public attention is focused on ensuring that the money spent on treating this increasingly chronic disease achieves the best outcomes for patients while minimizing their suffering. The delivery of high-quality care is now widely recognized as the best way to ensure value for the healthcare dollars spent. Employers, consumers, and governmental organizations—including the largest payer for healthcare services, the Centers for Medicare & Medicaid Services (CMS)—all agree on this point. However, if we are to continue helping our patients benefi t from the best that medicine has to offer, community oncologists must step forward to actively champion the development of quality standards and programs. These programs must be integrated into the network of community cancer clinics, which remain the most cost effective, responsive, and compassionate venues for the care of Americans with cancer. Although it’s a daunting task just to keep current with the increasing amounts of data on new therapies for cancer and blood diseases, it’s not enough. A number of community oncologists have