Cancer Care Headlines 2021

by Don Jewler, Director of Communications, ACCC

Heard at ACCC’s 37th Annual National Meeting on Saturday, March 25: Technology will continue to shift cancer service utilization over the decade.

So, prepare now, cancer programs.

Future growth will not be on the inpatient side of cancer care, said Rebecca Booi, PhD, of the healthcare consulting company Sg2. She projects only a 9 percent growth in inpatient admissions, which is below population growth (22 percent) over the same timeframe. Be careful, she advised. Don’t overplan for demand you may not see. Innovation and technology will take volume from the inpatient setting and shift it to the outpatient setting. Outpatient volume is estimated to grow by 36 percent over the decade. Plan now for this increase, she said.

Cancer centers should prepare for increased infusion volumes by coordinating care and work patterns. Booi cited steps taken by ACCC-member Cleveland Clinic at Hillcrest Hospital in Ohio to streamline infusion center operations. (Read more about this cancer center’s experience in Oncology Issues Nov/Dec 2009.)

What can you do to capture growth? Booi examined strategies for building breast, colorectal, and prostate cancer services.

Diagnostic and therapeutic advancements will drive growth in breast cancer care. Sg2 projects screening mammography services utilization to increase 39 percent over the decade, diagnostic mammography, 40 percent, and chemotherapy, 38 percent. Cancer programs should focus on operational efficiencies that shorten time frames for breast cancer screening to diagnosis. Find where there is waste in the process. For example, Gundersen Lutheran in La Crosse, Wisconsin, said Booi, designed a 7-day detection to treatment plan time frame to reduce negative biopsy rate with its multidisciplinary team approach and a dedicated breast health specialists. Baptist Memorial Hospital for Women in Memphis doubled daily screenings without additional staffing or equipment. They improved time frames by focusing on efficiency, establishing a prioritization system, and adjusting business hours. Arrival to departure time was reduced from 2 hours to 30 minutes, and screening to diagnostic mammogram to biopsy reduced from 21 to 17 days.

Colorectal cancer screening drives inpatient and outpatient growth, said Booi. Increase your screening rates to drive downstream surgeries, chemotherapy, and imaging. CRC screening rates are distressingly low because, patients report, they never thought about it. Cancer programs should increase screening rates by targeted marketing and outreach so patients do think and act. (ThedaCare marketing combines patient targeting lists with robust marketing, said Booi.)

For prostate cancer, radiation therapy and visits yield a significant revenue source. IMRT will continue to dominate the landscape for prostate cancer. Booi projected a 45 percent growth in this decade. Proton beam therapy (PBT), too, will experience large growth, with a doubling of treatment rooms over the next decade. (Although the reimbursement structure for PBT remains attractive for now, it is questionable in the long term, said Booi. Still, with sound business models, profitability is attainable. If your program is considering PBT, Booi strongly suggests partnering with another facility to share the costs.)

The great growth in outpatient volume in prostate cancer visits, can’t all be in person, said Booi. About half of these visits will not be face-to-face. Instead, growing information technology capabilities will allow for new, different, and improved communication with providers, producing superior coordinate care.

Bottom line: There’s much cancer programs can and should do now to prepare for 2021.