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ASCO warns of increasing demand, costs for cancer care amidst decreasing access to oncologists

Wednesday, April 02 2014 | Comments
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The American Society of Clinical Oncology (ASCO) released a new report highlighting the challenges of providing cancer care as the demand for and costs of cancer treatment are expected to increase, while the number of oncologists is not expected to keep pace.

The report, titled The State of Cancer Care in America: 2014, also warned of economic pressures that may force the closure of small physician practices, decreasing access to care in rural areas.

Despite treatment advances leading to a dramatic decline in cancer deaths in recent decades, the number of new cancer cases in the United States is projected to increase 45 percent, from 1.6 million cases to 2.3 million cases annually, by 2030, due in part to an aging population and lifestyle changes, according to the report.

The cost of cancer care in the United States is predicted to hit $17 billion by 2020, which represents a 40 percent increase from 2010.

In the face of these increasing demands, the number of oncologists will likely increase only 28 percent by 2025, the group said, citing an aging oncology workforce and impending wave of physician retirements as limiting the growth.

ASCO said the gap between the demand for care and the number of new oncologists expected translates to a projected deficit of 1,487 physicians, leaving an estimated 450,000 new patients who are likely to face obstacles in getting care.

The projected shortage of oncologists comes amidst growing concerns about the survival of smaller independent practices, especially in rural communities. According to an ASCO survey of 530 U.S. oncology practices representing more than 8,000 oncologists, almost two-third of oncology practices with one or two physicians, the most likely to serve rural areas, said they are likely to merge, sell or close in the next year.

The report also included recommendations for improving the quality and value of cancer care and lessening the impact of the oncology workforce shortage. These recommendations include the increased use of advanced practice nurses and other non-physician providers, as well as new health care payment and delivery models that reward high-quality care, reduce administrative burden and better compensate practices for the services needed by patients with cancer.

ASCO also called for an end to sequester-related cuts to Medicare physician payments and to the sustainable growth rate formula, Medicare's current reimbursement system, which the group said has "become a source of tremendous instability within health care and a perennial threat to care for millions of seniors."

"We're facing a collection of challenges, each one of which could keep cancer treatment advances out of reach for some individuals," said Dr. Clifford Hudis, president of ASCO. "Collectively, they are a serious threat to the nation's cancer care system, which already is straining to keep up with the needs of an aging population. Without immediate efforts to address these threats to oncology practices, we're at real risk of failing tomorrow's cancer patients."

The report was published online March 10 ahead of print by the Journal of Oncology Practice.

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