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Workshop participants also suggested ways to improve the affordability and quality of cancer care. Box 1 highlights possible solutions proposed by individual participants. Beginning on page 29, the workshop summary describes possible solutions in more detail, organized by:

  • patient and clinician communication and education
  • best practices in cancer care
  • evidence base for clinical practice and reimbursement
  • financial incentives aligned with affordable, high-quality cancer care
  • delivery system and reimbursement changes

A recurring theme of the workshop was the need for all stakeholders—including patients, clinicians, private and government payers, and the pharmaceutical and device industries—to work together to address affordable cancer care. In addition, several workshop speakers suggested that strategies for controlling cancer care costs are likely to be applicable to reducing health care costs in general. “Because cancer is such a prevalent set of conditions and so costly, it magnifies what we know to be true about the totality of the health care system. It exposes all of its strengths and weaknesses,” explained Susan Dentzer, editor in chief at Health Affairs. Mark McClellan, director of the Engelberg Center for Health Care Reform at the Brookings Institution, concurred, adding, “Oncology is where the action is going to be. There will be modifications called for in the Affordable Care Act that will put more pressure on finding ways to lower cancer care costs while improving quality and innovation.” IOM President Harvey Fineberg agreed: “If we can find a way to solve this problem for cancer care, then we have the keys to solve it for health care more broadly.”

Workshop presentations and discussions will also inform an ongoing IOM consensus study, Improving the Quality of Cancer Care: Addressing the Challenges of an Aging Population. The study committee is examining issues in the quality of cancer care, including a specific focus on how the aging of the population will rapidly accelerate the number of new cancer diagnoses at a time when workforce shortages are predicted. The committee’s report is expected to be released in 2013.


Workshop speakers presented statistics that underscore the severity of the problem of health care spending and the need for immediate solutions.

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