Abstract
BackgroundIn 2007, the National Cancer Institute (NCI) launched the NCI Community Cancer Centers Program (NCCCP) as a public-private partnership with community hospitals with a goal of advancing cancer care and research. In order to leverage federal dollars in a time of limited resources, matching funds from each participating hospital were required. The purpose of this paper is to examine hospitals’ level of and rationale for co-investment in this partnership, and whether there is an association between hospitals’ co-investment and achievement of strategic goals.MethodsAnalysis using a comparative case study and micro-cost data was conducted as part of a comprehensive evaluation of the NCCCP pilot to determine the level of co-investment made in support of NCI’s goals. In-person or telephone interviews with key informants were conducted at 10 participating hospital and system sites during the first and final years of implementation. Micro-cost data were collected annually from each site from 2007 to 2010. Self-reported data from each awardee are presented on patient volume and physician counts, while secondary data are used to examine the local Medicare market share.ResultsThe rationale expressed by interviewees for participation in a public-private partnership with NCI included expectations of increased market share, higher patient volumes, and enhanced opportunities for cancer physician recruitment as a result of affiliation with the NCI. On average, hospitals invested resources into the NCCCP at a level exceeding $3 for every $1 of federal funds. Six sites experienced a statistically significant change in their Medicare market share. Cancer patient volume increased by as much as one-third from Year 1 to Year 3 for eight of the sites. Nine sites reported an increase in key cancer physician recruitment.ConclusionsDemonstrated investments in cancer care and research were associated with increases in cancer patient volume and perhaps in recruitment of key cancer physicians, but not in increased Medicare market share. Although the results reflect a small sample of hospitals, findings suggest that hospital executives believe there to be a strategic case for a public-private partnership as demonstrated through the NCCCP, which leveraged federal funds to support mutual goals for advancing cancer care and research.
Highlights
In 2007, the National Cancer Institute (NCI) launched the NCI Community Cancer Centers Program (NCCCP) as a public-private partnership with community hospitals with a goal of advancing cancer care and research
This paper presents study findings that explore (1) the extent to which hospital executive management believed there to be a strategic case for participation and the specific outcomes that comprised the strategic case, (2) the level of investments made by the participating hospitals, and (3) whether the total investments were associated with changes in the strategic outcomes specified by hospital executive management
Several sites had limited capacity or history with conducting clinical trials research, working with disparate populations, and/or coordinating care across the cancer continuum to ensure that patients received evidence-based, timely care
Summary
Cancer is a complex disease that requires broad engagement of various clinical specialists and organizations to develop a patient-centered delivery system that integrates scientific discovery and provides highly coordinated, evidence-based multi-specialty care across the care continuum. While these systems are wellestablished in many of the largest cancer centres in the United States, not all patients have access to these centres. To promote access to the same high-quality care for patients, regardless of residence, the National Cancer Institute (NCI), one of the 27 institutes of the National Institutes of Health, designed the Community Cancer Centers Program (NCCCP) pilot as a public-private partnership to accelerate the diffusion of the latest science to local communities. In addition to receiving federal funds, each organization was expected to contribute institutional dollars (i.e. matching funds) to cover NCCCP-related activities including redesigning care processes and organizational structures; the amount of matching funds was not specified
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