How to judge the cancer services benefit component of your health insurance plan
✍ Scribed by Lee E. Mortenson
- Publisher
- John Wiley and Sons
- Year
- 1998
- Tongue
- English
- Weight
- 109 KB
- Volume
- 82
- Category
- Article
- ISSN
- 0008-543X
No coin nor oath required. For personal study only.
✦ Synopsis
published clinical research, epidemiology, and tumor registry information, expect businesses to evaluate the quality of cancer care using classic scientific methods. Association of Community Cancer Centers, Rockville, Maryland.
However, businesses lack sophistication in these data and tend to use significantly different criteria relating to cost, service, and access. Logistical problems also abound, such as the wide variety of cancers, small sample sizes, and the frequency with which patients change insurance plans.
METHODS.
Adapting an approach first proposed by Donabedian employing criteria that can be measured, easily gathered, and whose presence/absence can be interpreted as having a consequence for patient care, the author proposes a system of evaluating cancer health care benefits.
CONCLUSIONS.
Recognizing that classic outcomes analysis is too complex and inappropriate for business, companies and oncology providers may be able to develop obtainable measures whose presence or absence has intuitive and documented relation to the quality of cancer care. Cancer 1998;82:2061-7. ᭧ 1998 American Cancer Society.
W hat criteria should business purchasers use in selecting oncology benefits from an insurer? A growing percentage of the money businesses spend for their health care benefits plan will be utilized for payment of oncology benefits. As the nation ages, so will the available workforce, and given that cancer is an illness that primarily affects significant portions of the population age ú 40 years, 1 the business community can expect an increasing share of their health care dollar to be spent on oncology. Indeed, the number of cancer patients receiving treatment is likely to triple over the next 30 years. Given that the American Hospital Association and others are suggesting that oncology will surpass cardiology as the number one health care cost by the end of this decade, it is easy to see why this area, accounting for 20% of all health care costs, is coming under increasing scrutiny.
Presented at the American Cancer Society Na-This article reviews some of the types of data available, suggests tional Conference on Purchasing Oncology Sercriteria that are easily obtainable by plans for presentation to the vices: Current Methods and Models in the Marbusiness community, and describes how these criteria can assist a ketplace, Chicago, Illinois, September 11-12, plan evaluator to discriminate between one plan's approach to cancer 1997.
care provision versus another.