Advances in care, changes in regulations and market forces contribute to a continually evolving health care system. Three market forces — an aging population, the increased cost of care and the availability of new technology — are combining to create the most impact on oncology patients, providers and payers.
As the population ages, their risk of being diagnosed with cancer substantially increases. Those 65 and older are actually nine times more likely to develop cancer than those under the age of 65. This adds more pressure to a health system already stretched thin.
And while payers are being called upon to reduce costs, the cost of treating cancer continues to climb. Value-based care is creating a sense of urgency for new cancer solutions while also driving consumer demand for greater transparency in pricing and treatment rationale. The average cost of oncolytics new to the market is well over $100,000. Many cancer patients today are prescribed a combination of these high-priced therapies.
The availability of new technology is necessary if we are to successfully support new oncology solutions and reduce waste in the health care system. It’s important that payers leverage technology to more easily share information with providers, and better align solutions with the needs of all stakeholders.
Consumer-centric care: the foundation of oncology solutions
Oncology solutions succeed when they are based on a consumer-centric model that includes people, processes and platforms capable of delivering proven value.
Patient care should be delivered through an integrated care team that includes clinicians whose specialty and expertise lie in oncology, along with social workers and in-field support teams. Services offered through this care team should be integrated with a clinical system that provides advocacy, pharmacy and behavioral support.
More than 50 percent of health care system waste is the result of medically inappropriate care. But by following evidence-based treatment guidelines, we can eliminate unnecessary and ineffective treatment from the system.
The oncology space presents unique challenges, but we can meet them by dedicating ourselves to:
- Connect providers to the tools that will support them in their treatment decisions.
- Align patients to the appropriate care.
- Refer members to the right facilities.
- Utilize case management services to provide members with ongoing support.
Watch the video, “Key fundamentals for oncology-based solutions,” for in-depth discussion of the three market forces impacting oncology, and the opportunities for consumer-centric solutions.
About the author
Heather Jarrett, Vice President of Specialty Solutions for Women’s Health, Optum
Heather Jarrett currently serves as the Vice President of the Specialty Solutions for Women’s Health and Oncology, and has been with Optum for three years. Previously, Heather worked with Alere Health, and held several different roles in Operations, Client Services, and Business Development for health plan commercial and government markets. Prior to Alere, Heather worked in the acute care setting as a charge nurse in Florida and Canada for over ten years. Heather holds an RN license in Florida and Georgia.