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Policy Change Aims To Lessen Health Care Disparities

 ALEXANDRIA, VA – To help address serious racial and economic disparities in cancer prevention, diagnosis, and treatment in the United States, the American Society of Clinical Oncology (ASCO) today released a policy statement that outlines specific provisions of 2010 Patient Protection and Affordable Care Act that have the potential to reduce these disparities.

Black News, African American News, Minority News, Civil Rights News, Discrimination, Racism, Racial Equality, Bias, Equality, Afro American NewsASCO’s statement makes recommendations to ensure that such provisions are carried out effectively, and urges additional steps to address systemic issues including insurance reform, quality of care, prevention, research, and diversity in the health care workforce.

ASCO’s statement, to be published in the Journal of Clinical Oncology, identifies specific measures to help eliminate cancer care disparities including:
• Adopting patient-centered quality improvement initiatives;
• Attracting more minority physicians and improving the training of the oncology workforce to meet the needs of racially and ethnically diverse patients with cancer;
• Improving data collection on cancer disparities and determine what must be done to make meaningful medical evaluations;
• Ensuring access to cancer specialists for all patients who seek treatment at federally qualified community health centers;
• Allowing for cancer-centered services to be at the direction of oncology professionals in community health centers and medical homes where many seek medical care.

“The Affordable Care Act provides a foundation for meaningful progress in eliminating disparities in health care,” said ASCO President Michael P. Link, MD. “However, many of its provisions are vague and open for interpretation. In addition, significant progress requires added measures that are not in the new law.”

Key Recommendations from ASCO’s Policy Statement

Improve Insurance Coverage
By increasing Medicaid eligibility, the Affordable Care Act has the potential to reduce the number of uninsured by 59 percent. However, 23 million individuals are estimated to be uninsured by 2019.

Oncologist Mary De Shields, MD, who practices in Maryland’s Eastern shore, learned first-hand that insurance coverage is one of the greatest factors accounting for disparities in care. “When I first came from Philadelphia to practice here, I spoke to many uninsured patients and people at church and community gatherings about the importance of cancer screening and prevention. When Maryland implemented screening programs, I began to see fewer patients with late stage cancers. Greater access to screenings and follow up testing improved outcomes for patients in my community,” Dr. De Shields said.

But a major concern of ASCO is that, evidence shows that with low reimbursement, cancer patients on Medicaid fare no better than patients who have no health insurance.

In Brooklyn, N.Y., Gina Villani, MD, MPH, serves a limited-income patient population that is about 85 percent minority. Dr. Villanni said, “I worry about care coordination and low Medicaid reimbursement rates that often force providers to neglect the underinsured.”

To ensure that Medicaid patients have consistent access to quality cancer care, ASCO is asking policy makers to:
• Provide Medicaid patients diagnosed with cancer with immediate, presumptive eligibility for Medicare
• Reimbursing doctors who treat cancer patients on Medicaid at Medicare rates.

In addition, separate from the Affordable Care Act, ASCO and other medical societies are calling on Congress to ensure that Medicare to fix a flawed payment formula known as the Sustainable Growth Rate, to ensure that patients have continued access to quality cancer care in the years ahead.

Enhance Prevention and Screening Follow Up
Although the health care reform legislation mandates that insurers cover certain cancer screenings, it does not expressly require insurers to cover follow-up tests if an abnormality is found. For example, if a polyp is found during a colonoscopy, insurers are not required by law to cover follow-up diagnostic examinations and biopsies. ASCO is calling for Congress to require insurers to cover appropriate follow-up testing without patient deductibles or copays.

“Many of my patients can’t afford copayments of five dollars or less for life saving medications, so they certainly can’t afford to pay for follow up medical testing,” Dr. De Shields said.

Meeting the Needs of Diverse Patients
Provisions in the Act direct the Secretary of Health and Human Services (HHS) to support the development of curricula for cultural competency programs, and effective in 2012, health plans’ summary of benefits and appeals processes are expressly required to be presented in a culturally and linguistically sensitive manner. For example, summaries must be written in plain language to be understood by those with limited English proficiency.

Dr. Villani said, “For many of our patients, the system can be overwhelming, especially when English is not the native tongue. So my hospital has instituted changes to make the facility more inviting and to provide extra support for patients who need help coordinating and navigating their care.”

Develop Quality of Care Measures
The new law also authorizes development of a strategy to develop and test measures to improve quality of care as a means to reduce disparities in health care.

ASCO strongly supports this measure, and has made great progress on improving the quality of cancer care over the last ten years. ASCO launched its national, data-driven quality improvement program, the Quality Oncology Practice Initiative® (QOPI) in 2006 after five years of research and development. QOPI is the first national program to help practices improve the quality of care they deliver and to certify outpatient oncology offices for meeting the highest national standards for cancer care delivery. Today, over 700 practices participate.

Dr. Villani said her hospital is interested in pursuing ASCO’s QOPI program. “Regardless of insurance coverage, patients deserve high quality care. By highlighting areas where my practice can improve, we can work together to provide better care,” she said.

Dr. Link explained. “When it comes to closing the disparities gap, quality does matter. A meaningful quality initiative must be based on best practices derived from clinical guidelines, published measures, and collective expert consensus. Care minus quality isn’t much better than no care at all.”


STORY TAGS: Black News, African American News, Minority News, Civil Rights News, Discrimination, Racism, Racial Equality, Bias, Equality, Afro American News



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