In every part of the cancer landscape, patient-focused care is becoming the highest aspiration. Here’s what every payer should know to fully embrace this increasingly ubiquitous — and beneficial — approach.
For generations, oncology care has largely centered around the treatment: this drug(s) for this form of cancer, this treatment regimen for this stage, this one-size-fits-most routine of follow-up care during the patient’s survivorship. Factors particular to the individual being treated — such as their unique values, preferences, priorities and concerns — often took a backseat. The patient was asked to conform to treatment, not the other way around.
There’s a seismic shift underway as patient-centric cancer care surges in demand and is steadily being proven effective. This new approach puts patients’ needs, desires, history, circumstances and direct involvement first. Their treatment aims to be more comprehensive and personalized, as well as accessible and understandable to the patient. By empowering patients to take a more active and educated role in their treatment, adherence rises and outcomes improve.
Like any major shift in health care, there are many dimensions to consider — from the drivers behind the trend to the impact on everything from member experience to payer pocketbook. As cancer care becomes more patient-centric, here’s what payers need to know.
1. Patient-centric care factors in countless aspects of a patient’s life, history and biology
Patient-centric care does more than simply orient treatment around the patient. It’s a fundamental rethink of how treatment should be approached. Rather than a biomedical model (in which the best treatment is a matter of pairing medicine to biology), patient-centric care is biopsychosocial. That means it considers the patient’s:1
- Immune function
- Tumor characteristics
- Psychological state
- Coping skills
- Personality traits
- Social aspects
- Socioeconomic status
- Strength of support networks
- Health literacy
Biology and medicine play a role, no doubt, but the best care plan is fine-tuned to the interplay of biology, psychology and social factors of that particular patient.
Holistic consideration of the many factors that shape someone’s cancer journey may be a potent lever for greater health equity. Consider, for instance, immune checkpoint inhibitors (ICIs), a treatment that’s attributed to the sharp decline in U.S. cancer mortality since approved by the FDA in 2011. Patient-centric cancer care applies a biopsychosocial lens to that medical innovation.
As researchers note in a 2023 Trends Cancer study, “Black patients who are treated with ICIs may experience higher rates of [immune-related adverse events] irAEs than white patients because of their enhanced immune response, but management of their irAEs may be negatively impacted by factors such as poor quality of care, racism, negative social determinants of health and other psychosocial stressors, which can lead to treatment discontinuation.”2
2. Patient-centric care improves member satisfaction
Intuition suggests that patient-centric care would make for happier patients — and the research backs that up. A 2023 study found that when oncologists used patient-centered communication, such as acknowledging and speaking to patients’ emotions, allowing them to ask all the questions they need to, and building personal relationships with them, their patients consistently perceived the quality of their care as high and reported a significant amount of trust in their doctor.3 Another study found that a group receiving patient-centric cancer care had a higher chance of participating materially in the decision-making around their care than a group receiving traditional treatments.4 And as we know from separate research, being meaningfully included as a collaborator in one’s medical decisions has a significant impact on patient satisfaction.5
“I would say that there has been a shift,” said Dr. Deb Schrag, medical oncologist and chair of the Department of Medicine at Memorial Sloan Kettering Cancer Center. “And now when we design clinical trials in cancer medicine, we pay a great deal of attention to not just traditional end points like survival and recurrence, but we also pay a lot of attention to patients’ well-being and function — during the treatment, but also long term.”6 In one such trial, younger patients with early-stage rectal cancer could preserve their future fertility by omitting the radiation therapy used in the traditional approach to treatment.
3. Patient-centric care reduces health care costs
A lot of time and thought goes into interacting with each patient using more thoroughly communicative guidelines. Designing a mode of care to suit these individual needs also adds up. While it may seem that this approach would cost more, the numbers simply don’t bear this hypothesis out.
One study found that the likelihood of person-centric care being more cost-effective for providers and payers than a traditional approach is 93%.7 Why? A patient-centered approach to treatment results in fewer ER visits, a speedier recovery period and a reduced need for further health care resources — leading to better patient and health outcomes.8
4. Patient-centric care is a natural fit for managed care programs
With a comprehensive managed care oncology program, many of the fundamentals of patient-centric care come standard. Providers within the program’s circle of care adopt a wide-angle picture of the patient’s support system, social context, comorbidities and other treatment factors. Through one-on-one interactions, a skilled and specialized oncology nurse helps patients navigate treatment while taking their particular needs into consideration. And robust wraparound services help ensure patients lessen common care barriers, while avoiding unnecessary hospitalizations.
With a surge in cancer incidence rates and costly treatment options, health plans are eager to rethink traditional approaches to connecting patients with the right care in the right place at the right time. Cancer managed care programs present a proven way to do just that, while also staying in lockstep with the larger trend toward patient-centric oncology care.
Learn about Optum Oncology Care Management Programs.