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As Local Cancer Centers Grow, Hospitals Seek to Advertise Superiority
Competition is building in the cancer-care field as hospitals, health systems, and physician groups construct new centers in response to the aging of the baby boomers and a projected increase in cancer diagnoses over the next 20 years.
An Advisory Board Company survey last year found that 28% of health systems it surveyed had built a new cancer center in the previous three years, according to Modern Healthcare. One study estimated there will be a 45% increase in cancer diagnoses by 2030. The National Cancer Institute (NCI) projects that cancer care spending may reach $207 billion by 2020, up from $125 billion in 2010.
As money is invested in new centers and providers compete for patients, they face the challenge of effectively marketing their cancer services to distinguish them from their competitors in terms of quality. That's particularly difficult for community hospitals that want to attract patients away from big-name cancer centers with NCI designations. Meanwhile, some experts are questioning the accuracy and ethics of cancer-care marketing campaigns, and those concerns are likely to become more widespread with the cancer-care boom.
Americans facing a cancer diagnosis traditionally have sought out prestigious centers in big cities. But as the number of patients grows — and as the approach to cancer care becomes more personalized with more social support — there's more demand for care at the local level, cancer experts say.
Hospitals and physician groups are responding to that demand. Some hospitals have built new cancer facilities after they purchased or affiliated with oncology practices, said Jessica Turgon, cancer services practice leader for ECG Management Consultants. “Systems are trying to provide one-stop shopping” to make cancer treatment easier on patients, she said.
The building spree raises questions about how consumers can know whether they will receive the same quality of care for their condition at a community hospital as they would get from a major cancer center. There are just 45 NCI-designated centers, while there are about 1,500 cancer programs accredited by the Commission on Cancer, which is run by the American College of Surgeons.
Dr. Randall Holcombe, chief medical officer for cancer care at Mount Sinai Health System in New York, said it's critical for a program not just to provide all the pieces of cancer care but to coordinate them. “Some places call themselves a cancer center but don't really provide coordinated care,” he said. “It can be a marketing ploy to encourage patients to come.”
To demonstrate their quality, some community hospitals are affiliating with a big-name center. MD Anderson Cancer Center, for example, plans to add up to six partner institutions that aspire to provide an MD Anderson level of care. The Houston-based center's plan also involves offering a network of community hospitals with “certified membership.” So far, 13 hospitals have joined that program. One of them, Community Health Network in Indianapolis, reports that in three years, its affiliation with MD Anderson has increased its volume of cancer patients by 250%.
For community hospitals that are building new cancer centers without the imprimatur of a prestigious cancer-care brand, their marketing usually focuses on the benefits of getting quality cancer care close to home. That's increasingly important to patients undergoing lengthy courses of treatment with difficult side effects.
“When it comes to the more common types of cancer, community hospitals are often well-equipped to provide excellent care,” said Lindsay Conway, managing director of research and insights for the Advisory Board. Baptist Health Paducah (in Kentucky) broke ground in September for an $8.3 million regional cancer-care center with private chemotherapy rooms, family space, laboratory, and physician offices, with a radiation therapy center next door. Its purpose is to pull Baptist's far-flung treatment centers into one location and offer a local alternative for patients who might otherwise travel 135 miles to Vanderbilt University Medical Center in Nashville, said Baptist Health Paducah President William Brown. He doesn't see the expansion as a challenge to Vanderbilt, where Paducah patients may still go for second opinions or highly specialized care.
In Maine, a rural state where most residents lack nearby access to an academic medical center, New England Cancer Specialists has adopted an oncology medical home model for its 13 oncologists, with each specialist leading a multidisciplinary team that provides comprehensive care. Steve D'Amato, the oncology practice's executive director, said that with the expansion of alternative payment models, the only way large oncology practices will be able to survive will be by providing comprehensive care. That includes access to clinical trials, genetic testing, oncological rehabilitation, functional medicine, long-term support for cancer survivors and palliative care, he said.
There is no generally accepted definition of the term cancer center. Facilities that call themselves cancer centers may offer any or all of an array of services, including diagnostic imaging, surgery, radiation therapy, chemotherapy, immunotherapy, access to clinical trials, support services such as physical therapy, rehabilitation, support for cancer survivors, nutrition, and palliative care.
In its accreditation program, the Commission on Cancer separates cancer programs into several categories, including integrated networks, academic programs, community-based programs, and free-standing centers. The NCI designates 69 comprehensive cancer centers that have a research orientation. The Association of Community Cancer Centers has about 20,000 members that work on multidisciplinary cancer teams in various settings. Then there is the Alliance of Dedicated Cancer Centers, 11 centers that have been exempt from Medicare DRGs since 1983 because of their focus on one disease.
Hospitals are most likely to tout the aspects of their cancer program that differentiate it from the competition, said health care marketer Chris Bevolo, executive vice president of consumer engagement at ReviveHealth.
Much cancer-center marketing and advertising is simple, emotional content, according to research published in the Annals of Internal Medicine in 2014. Its analysis of magazine and TV ads by 102 cancer centers in 2012 found that 85% used emotional appeals, 61% evoked hope for survival, and 41% depicted cancer treatment as a fight or battle. Treatments were promoted in 88% of the ads and 27% described their benefits, but only 2% talked about treatment risks and just 5% mentioned cost or insurance coverage.
An Advisory Board survey of about 400 former cancer patients found that accreditation was not important to them in evaluating potential providers. Their top concerns were a doctor who specialized in the patient's type of cancer, the center's technology and treatment options, and its clinical quality.
Source: Modern Healthcare, November 16, 2015.