FIXED-PRICE PROTOCOL FOR DIAGNOSIS AND COMPREHENSIVE PLAN FOR INTEGRATED CARE POISED TO BECOME AN OPTION FOR CANCER PATIENTS

By Alice Goodman

A novel approach whereby consumers (patients) can obtain a rapid diagnosis and fully integrated care plan at a fixed cost promises to revolutionize the way cancer patients are currently managed. Cancer Treatment Centers of America (CTCA), a group that currently comprises 4 full-service cancer hospitals offering state of the art treatment and technology, has developed a unique fixed-price protocol for diagnosing and developing a comprehensive treatment plan for the most common types of cancer – including prostate, breast, lung, and colorectal cancers. The fixed-price protocols for these cancers will be rolled out in about 60 days and will range from $10,000 (prostate) to $14,200 (breast). Future plans are to offer fixed pricing plans for less common cancer types.

“Currently most cancer patients are referred by their family physician to an oncologist and once the diagnosis is made, the patient is subjected to several tests that are ordered piecemeal. It takes a protracted amount of time to get a full diagnosis and come up with a treatment plan – about 2 to 3 months. The cancer patient seldom if ever knows the cost of this care. The process is stressful, disabling, and disruptive for patients, and some aggressive cancers can continue to advance during this time,” explained Stephen Bonner, CEO of CTCA.

“Our fixed-price protocol and care model aims to engage the consumer in this process, giving them understandable and usable information and putting consumers in the buying role. This will make the prices [of diagnosis and care] competitive.” Bonner estimates that coming up with a full diagnosis and comprehensive care plan within the CTCA model of services will be guaranteed to take no more than 5 days, he said, instead of 2 to 3 months.

“We will guarantee a price for a full panel of diagnostic tests and an initial care plan that includes sophisticated treatments and techniques,” Bonner stated.

CTCA hospitals presently exist in Philadelphia, Illinois, Oklahoma, and Arizona. A fifth hospital will open in Atlanta some time in the fall of 2012. Currently, about two thirds of the patient population at CTCA hospitals have late-stage or complex cancers that have been treated elsewhere and treatment options may have been exhausted; the other third are newly diagnosed cancers, Bonner said.

The array of integrated services offered at CTCA hospitals includes the most sophisticated techniques and approaches for chemotherapy, radiation, surgery, nutrition, naturopathic medicine, psychoneuroimmunology (mind-body medicine), and psychosocial and spiritual support. An important aspect of the care plan that differs from treatments at most other cancer centers is that the services are integrated, because the various practitioners collaborate and confer about patient care for each patient.

Bonner says that CTCA is currently in discussions with employers and insurers about coverage for the single fixed-price service they plan to introduce. “We want to take the ‘administrivia’ out of the health care system,” he stated.

What does it cost for a comparable diagnostic and comprehensive care plan at other hospitals/clinics? Bonner and his associates have tried to find this out, with no success. “We’ve done some secret shopping, and have not been able to find out what competitors charge for a thoughtful and complete diagnosis. It is not easy to get a cost for the aggregated pieces of the different services involved.”

Currently, CTCA has done outcomes research including:

• Studies tracking the length of life by type of cancer and disease stage compared with the NCI database.
• Quality of life of patients treated at CTCA hospitals compared with European Organization of Research and Treatment of Cancer (EORTC) norms for quality of life for similar types of cancer.
• Surveys showing what it is like to be a patient at each of the CTCA hospitals according to the Bain Net Promoter Score.
• About 100 abstracts in peer review journals about how the medical and holistic therapies provided at CTCA hospitals work together.

Results of the first 3 types of studies/surveys are available on the CTCA website.

“Our approach is based on a consumer-driven model. The current models disengage the consumer from the process of shopping for high quality, cost-conscious care. We are letting insurance companies make decisions for patient care. There is no way this can lead to higher quality care and better cost. All the trend lines are converging to suggest that if you give consumers understandable and usable information and put them in the buying role, the cost will be contained,” Bonner said.

Although the fixed-price approach is theoretically attractive, it may not actually translate to improved care at CTCA hospitals. For a more in depth look at consumers’ and employees’ experiences with CTCA hospitals, please see the following Web sites: http://csn.cancer.org/node/179783 and www.glassdoor.com.

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  1. I am a practicing Md in OC Calif Several patients have returned to our practice after being seen at Cancer center of america. they do not follow any national guidelines and are a true rip off. So here is another schema fixed price for poor quality care with no data

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