Improving Cancer Care in a Kentucky Managed Care Plan: A Case Study of Cancer Disease Management

Abstract

CHA Health (CHA) is a provider-owned managed care plan serving a predominantly rural membership in Kentucky. Quality Oncology, Inc. is a national disease management company specializing in cancer care. This paper reports the results over the first 2 years of a cancer disease management program installed at CHA. The authors also review the evidence-based health services research that has guided the development and implementation of the program. The authors conclude that cancer is a disease state where specialized management can improve efficiency, treatment effectiveness, patient coordination, and outcomes reporting.

Implementing and Measuring the Impact of Patient Navigation at a Comprehensive Community Cancer Center

“…The most common approaches used by navigators often are based on individualized assessment and identification of patient-specific needs, resources, and barriers and include mobilizing financial assistance, coordinating services and appointments, providing education (Dohan & Schrag, 2005;Steinberg et al, 2006), and offering psychosocial support and advocacy (Wells et al). Core components across programs include education, provider coordination, and patient advocacy (Costich & Lee, 2003;Sweeney, Halpert, & Waranoff, 2007).…”

“…Outcomes of patient navigator programs reported in the literature include an increase in timely screening services, promotion of timely treatment after a suspicious finding, improved adherence to treatment regimens, and increased patient satisfaction with care (Costich & Lee, 2003;Dohan & Schrag, 2005;Ell et al, 2007;Ford et al, 2004;Freeman & Chu, 2005;Goodwin et al, 2003;Jennings-Sanders et al, 2005;Schwaderer & Itano, 2007;Steinberg et al, 2006;Sweeney et al, 2007;Vourlekis et al, 2005). Patient navigation also has been associated in the literature with increased cost effectiveness of care and increased patient satisfaction (Dohan & Schrag; Freeman & Chu; Goodwin et al; Jennings-Sanders et al; Schwaderer & Itano; Sweeney et al; Vourlekis et al).…”

Is Disease Management Right for Oncology?

“…This reduces the number of ER visits made by patients to replenish their supply of pain medications. 17 In the past there were concerns that opioids could accelerate cancer patients' deaths. However, evidence now shows that end-of-life hospice patients must be adequately medicated for pain, and there is insufficient evidence to support the theory that opioids hasten death.…”

“…Overall patient satisfaction with the program was 4.64 (1-5 scale), and physician satisfaction was 3.62 in year 2. 17 What Does the Future Hold?…”