Five years ago, if a cancer patient at Cooper University Health Care in Camden, N.J., had a complex case, the attending oncologist would review the medical literature and call colleagues to solicit input on the best course of treatment.
Now physicians can present challenging cases to a tumor board made up of experts in that particular form of cancer who come from Cooper and the University of Texas MD Anderson Cancer Center, one of the nation's top-ranked academic oncology centers. The two institutions formed the partnership in 2013.
“It's a very easy dialogue because we have this relationship,” said Dr. Generosa Grana, director of the MD Anderson Cancer Center at Cooper.
Cooper is among the growing number of hospital systems that are joining forces with renowned National Cancer Institute-designated centers such as MD Anderson based in Houston or Dana-Farber in Boston. Many regard these relationships as necessary to preserve quality and expand access to state-of-the-art oncology care. They also acknowledge that in an increasingly competitive market, association with a brand name oncology center helps attract patients.
“Folks are looking at ways to improve their position and access more patients,” said Jessica Turgon, who leads the oncology practice at ECG Management Consultants, where she is a principal. “There's a marketing element to all of this.”
But improving the quality of care is at the heart of the movement. “Community physicians get to leverage that knowledge base,” Turgon said. “It's good for everybody.”
About 1.7 million people a year are diagnosed with cancer, according to the National Cancer Institute. The cost of their care is projected to surge 25% from $125 billion in 2010 to $156 billion by 2020.
Cancer treatments are increasingly complex and tailored to the individual, and the best treatment must tap into medical advances that harness the power of genetics or the immune system. That highly specialized knowledge is usually found in the nation's pre-eminent cancer centers.
Yet patients increasingly desire to access their care closer to home where it is less expensive, which matters a lot as the price of cancer drugs skyrockets and an increasing number of patients are in high-deductible health insurance plans. When community hospitals join forces with the experts at cancer centers, they can tap those resources and expertise for patients with complex cases without having to send them away for more expensive treatment.
It also gives patients greater access to clinical trials that test experimental medicines. According to Dr. Stan Gerson, president of the Association of American Cancer Institutes and director of the Case Comprehensive Cancer Center, the proportion of patients involved in clinical trials ranges from about 2% to 3% in large community-based practice groups to 8% to 10% at most comprehensive cancer centers with the most highly specialized academic facilities enrolling as many as 20% of their patients in trials.
“That's a tenfold range of the opportunity for a patient to participate in a clinical trial, which is huge,” Gerson said. “We know that patients really do benefit from early-phase as well as late-phase clinical trials,” he added, although he cautioned against generalizations about the benefits of these trials for a disease as complex as cancer.
Comprehensive data showing the breadth and depth of these partnerships across the U.S. haven't been gathered yet. Gerson said the AACI is developing a survey of its 95 members to determine how partnerships have changed in nature and number in recent years.