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NCCN Trends™ Kiosks Explore Measuring Quality in Oncology; Familiarity of Health Insurance Marketplaces

Jake B. Guinto, PhD, Manager, Oncology Drugs & Biologics

Three NCCN Trends™ Kiosk surveys were conducted at the NCCN 18th Annual Conference: Advancing the Standard of Cancer Care™. The March 25, 2013 issue of NCCN eBulletin featured the first of the three summaries, “Revisiting Biosimilars and Molecular Testing in Oncology.” This issue highlights data from the second and third installments of NCCN Trends™ Kiosk surveys, which covered the topics of Measuring Quality in Oncology and Health Insurance Marketplaces, respectively.

Measuring Quality in Oncology
Standardized quality measurement programs are employed to assess the quality of cancer care within practices. In addition, managed care organizations utilize quality measures to ensure that their beneficiaries receive the best care possible for a reasonable cost.

To gain a better understanding of measuring quality in oncology, the National Comprehensive Cancer Network® (NCCN®) conducted an on-site NCCN Trends™ survey at the NCCN 18th Annual Conference in Hollywood, FL from March 13 – 15, 2013. The survey participants included various oncology stakeholders (e.g. physicians, nurses, pharmacists, and others [n=68]) and focused on practices' utilization of quality measurement programs and their usefulness, as well as consideration of the patient experience when measuring quality of cancer care.

NCCN first asked participants if their practices are involved in any quality measurement programs. According to the results, 86 percent of the survey participants said their practice is involved in a quality measurement program, as opposed to 14 percent who said their practice is not involved in any quality measurement program (Figure 1).

Next, NCCN asked participants which aspects of the patient experience they consider through practices' quality measurement program(s). As seen in Figure 2, 75 percent of the survey participants consider 'Avoidance of toxicity / adverse events' when assessing quality of cancer care through their quality measurement program(s). Participants also indicated that 'Speed of completeness of recovery' and 'Avoidance of financial hardships' are included in their quality measurement programs (52 percent and 44 percent, respectively). Thirty-five percent of participants consider 'Length of time away from family and work' in their quality measurement programs.

For practices currently involved in a quality measurement program, NCCN asked participants whether they view these programs as useful. According to the results, 73 percent of survey participants view quality measurement programs that assess quality of care as 'Moderately useful' to 'Very useful' (Figure 3). Twenty percent indicated that these programs are 'Somewhat useful', with four percent answering 'Slightly useful' to 'Not at all useful.'

In summary, although the sample size is small, the results may suggest that the utilization of quality measurement programs is occurring with increasing frequency (Figure 1). In addition, most participants find these programs useful for increasing the quality of cancer care.

Familiarity of Health Insurance Marketplaces
In March 2010, President Barack Obama signed The Patient Protection Affordable Care Act (Affordable Care Act) into law as a way of making health care more accessible. Under the Affordable Care Act, each state must begin to offer a selection of health insurance plans through a state-based Health Insurance Marketplace (also known as the Affordable Insurance Exchange), scheduled to go into effect in 2014. Open enrollment for a plan through the Health Insurance Marketplace will begin in October 2013.

To assess the level of familiarity of this aspect of the Affordable Care Act, NCCN conducted an on-site NCCN Trends™ survey at the NCCN 18th Annual Conference. The survey participants included various oncology stakeholders (e.g. physicians, nurses, pharmacists, and others [n=57]).

When NCCN asked participants their familiarity with the state-based Health Insurance Marketplace, only 27 percent answered 'Moderately familiar' to 'Extremely familiar.' Twenty-two percent noted they are 'Somewhat familiar', with more than half (51 percent), responding 'Slightly familiar' to 'Not at all familiar' (Figure 4).

NCCN also asked participants if their practice plans to accept patients acquiring insurance through state-based Health Insurance Marketplaces. According to the results, 59 percent of practices plan to accept patients acquiring insurance through Health Insurance Marketplaces. Seven percent do not plan to accept patients acquiring insurance through Health Insurance Marketplaces, with 35 percent of the participants 'Not sure' (Figure 5).

Although the survey represented a small sample size, the results do suggest that more education is needed among oncology stakeholders regarding Health Insurance Marketplaces. The majority of participants noted their practices (59 percent) do plan on accepting patients acquiring health insurance through Health Insurance Marketplaces (Figure 5); however only 27 percent of survey participants are 'Moderately familiar' to 'Extremely familiar' with these programs (Figure 4). With open enrollment beginning in October of this year and implementation of new plans in 2014, the needs for oncology stakeholders to become more familiar with Health Insurance Marketplaces is imminent.

In November 2013, NCCN will hold an invitation-only patient advocacy summit. This summit will bring together patients, providers, policy-makers, industry, payers, government, and other stakeholders for an in-depth discussion of the Affordable Care Act, including essential health benefits and how they are defined, as well as the impact of state-based Health Insurance Marketplaces on patients with cancer and the care they receive.

NCCN Trends™ is a survey-based analytics tool from NCCN that focuses on how clinicians in the United States and abroad deliver cancer care. NCCN Trends™ surveys pose questions regarding topics including, but not limited to, patterns of care, and awareness and utilization of various treatment modalities, as well as key topics impacting oncology stakeholders.

Data is gathered through brief electronic surveys to more than 200,000 health care providers who access the NCCN website on a frequent basis and express interest in responding to NCCN Trends™ Surveys. These clinicians consist of practicing physicians in diverse practice settings, including academic/research cancer centers, community hospitals, and private practices. Survey participants also include pharmacists, nurses, and other oncology stakeholders.

To learn more about NCCN Trends™ Surveys and Data, to commission a survey, or to discuss a customized survey, please contact Jake B.Guinto, PhD, Manager, Oncology Drugs & Biologics.