Stronger Primary Care, Oncology Partnerships May Improve Patient Outcomes: Mark Fendrick, MD

The more primary care providers partner with oncologists, the better the outcomes for patients with cancer, Mark Fendrick, MD, director of the Center for Value-Based Insurance Design at the University of Michigan and co–editor in chief of The American Journal of Managed Care®, explains in an interview at the Patient-Centered Oncology Care® conference in Nashville, Tennessee.

Watch part 1 to learn more about the importance of relationships between primary care physicians and oncologists and what makes handoffs between the 2 providers successful.

This transcript has been lightly edited; captions were auto-generated.

Transcript

How do financial barriers, coverage gaps, or lack of awareness of policy changes affect timely cancer screening and referrals? What strategies can help overcome these challenges?

Coverage gaps are a very important area and covered in all of The American Journal of Managed Care and MJH [Life Sciences] areas, because if patients can't afford to get the care they need, they either decline their use, which is very problematic, or get the care, which may lead to medical debt, sometimes bankruptcy, and the need for online fundraisers. Policies are underway to try to close that gap, both for preventive measures, such as cancer screenings, as well as treatments.

While there's been bigger progress in terms of our ability to reduce coverage gaps and reduce out-of-pocket costs, specifically for preventive screenings, it's not as widely implemented for the issue of treatment. It's very, very important for clinicians and their patients to discuss not only the clinical ramifications and the physical ramifications of the treatments that are forthcoming but what the financial implications of those treatments might be.

How has technology been effectively used in care transitions, and how should it be balanced with support from care coordinators?

We're always trying to close the gaps, to make sure that we put the patient first and things don't fall through the proverbial cracks. With the care that's necessary for a complicated cancer patient, you can imagine, there are multiple opportunities for the system to fail. The more secondary types of interventions that we might have, whether they be human or intelligence, such as artificial intelligence, or EMR [electronic medical record] reminders, or other types of things that will allow us to make sure that the care that needs to be delivered is actually delivered to the right patient, at the right time, in the right place, is critical.

All I could say is it's becoming more and more complicated to be a patient with cancer, given what's going on. Some patients go to a different place to get one aspect of their cancer care. They may get their radiation therapy in one place, they might get their chemotherapy or other infusions in another, and they may see their primary care medical oncologists in a completely different location. Add on top of that the need to understand literacy and understand the fact that there are financial implications at every step, makes it really important to us to put the patient first and have this care be as coordinated as possible.

How can formal partnerships between primary care and oncology improve care transitions?

The more primary care providers can partner in a real way with specialists, like oncologists, the better patient outcomes will be. I know that sounds very intuitive, but because the system has become so complex and the intervention so complicated, it's extraordinarily important that we not only see medical information being transmitted from one partner to another but also information about other potential barriers or concerns that a patient might have that might allow or preclude the delivery of necessary care.