Taking Steps to Address Cancer: Enhance Value, Reduce Costs

Last year, MD Anderson President John Mendelsohn, M.D., proposed 10 steps that can be taken to ensure cancer deaths decrease more rapidly, the ranks of survivors swell, and an even greater number of cancers are prevented in the first place.

This is the last in a series of posts on key actions outlined by Mendelsohn:

10. Enhance the value of cancer care and reduce costs.
New therapies and medical instruments and devices are major contributors to the rising cost of medical care in the United States. The current payment system incentivizes their use and rewards procedures, tests and treatments rather than rewarding outcomes and efficiency. A number of key issues need to be addressed:

• Methods of payment for health care that incentivize providers to strive for the best outcomes at the lowest cost -- often referred to as the "value proposition."
• Increased understanding of which diagnostic tests, treatments and services improve health and which are unnecessary.
• Dissemination of transparent information about the results and costs of tests, treatments and services offered by various providers of health care.
• Increased insurance coverage of prevention and risk assessment.
• Education and incentives to increase acceptance by the public of personal responsibility for their own health and to promote healthier lifestyles.

In addition, we can improve the quality of care and reduce costs by continuing our efforts to reduce medical errors.

A standardized, structured electronic medical record, accessible nationwide, is essential to ensuring quality care for patients who see multiple providers at multiple sites, and we are far behind many other nations.

Beyond that, a national electronic medical record could provide enormous opportunities for reducing overhead costs, identifying factors contributing to many illnesses (including cancer), determining optimal treatment and detecting uncommon side effects of treatment.

What the future holds in store
I am optimistic. I see a future in which more cancers are prevented, more are cured and, when not curable, more are managed as effectively as other chronic, life-long diseases. I see a future in which deaths due to cancer continue to decrease.

Achieving that vision will require greater collaboration among academic institutions, government, industry, health care payors and the public. Barriers to quality care must be removed. Research must have increased funding.

Mindful that our priority focus is on the patient, we must continue to speed the pace of bringing scientific discoveries from the laboratory to the bedside. We must incentivize both the delivery of less expensive care and the acceptance of personal responsibility for lifestyle and behavioral factors that influence health, like tobacco use and obesity.

It will be a team effort.