Cancer is one of the most dangerous diseases on earth. It has continued to affect a lot of people within the last few decades.

There are different forms of cancers depending on where the abnormal cell growth occurs. Thyroid cancer is one of the rare cancers that have been affecting many people, especially in the US. However, the good news is that it can be detected at early stages and easily treated.

Although thyroid cancer can be treated, not all people can afford the expensive surgery required to treat the disease. With that in mind, a medical reform act in Massachusetts was formed to provide affordable health care insurance programs for thyroid cancer surgeries to the less privileged especially the non-white citizens of Massachusetts. The effect of this affordable insurance policy was a 26% increase in patients who were successfully treated for the disease and another 22% who received neck surgeries for different thyroid related diseases.

The aim of the reform was to curb the rate at which thyroid cancer was growing. Within a decade the growth rate of this cancer was at 5%. Although there were some instances when the cancer was misdiagnosed, the growth rate was still alarming.  Today, though in not so many cases, minor infections or growth in thyroid gland are misdiagnosed as cancer forcing patients to go through unnecessary surgeries.

The insurance policy reforms has with no doubt allowed patients to access good medical care. The research was also a good place to start a deeper research on racial discrimination when it comes to accessing medical care, as well as probable misdiagnosis of thyroid-related diseases by doctors for reasons yet to be fully understood.

All in all the 2006 Massachusetts health reform, a model for the Affordable Care Act, saved lives of defenseless people and gave them a second chance at life.

Cancer treatment is constantly changing and it leads to fighting from drug makers and insurers in regards to coverage and the price of chemotherapy.

Drug makers want to ensure patients receive the chemotherapy drugs, but insurers want to limit coverage or require a higher co-payment for certain treatments.

In a recent case in Arkansas, drug makers won a battle in regards to chemotherapy. The governor of the state determined that private insurance providers could not charge more for chemotherapy when taken orally rather than through an infusion at the medical facility. As a result, chemotherapy taken through a pill will be more affordable to cancer patients. Arkansas was the 43rd state to sign similar legislation in regards to chemotherapy and patient groups continue to push for other states to engage similar solutions in regards to insurance coverage.

The insurance providers want to set prices for different services, even when patients take the same medications in a different form. The recent legislation brought the battle between insurance providers and drug makers into the spotlight because it pointed out a problem within insurance coverage. While it is not yet clear whether the private insurance providers or the drug makers will win cases in the states without provisions in regards to chemotherapy, it is likely that the push for similar pricing and co-pay on chemotherapy will persist into other states.

For patients, the legislation is a bright area that makes it possible to seek treatment for cancer. It gives patients hope that they will not end up spending more on their treatments when they have options in relation to their medications.

A recent Senate bill would encourage the use of Oncology Medical Homes, making cancer treatment more affordable and effective.

Although most people associate medical breakthroughs with advances in technology, changes in the way we apply existing tech are every bit as important.

Oncology Care Overview

The Oncology Medical Home model is a strategy designed to lower the cost and increase the effectiveness of cancer treatment. The model is based on five key principles:

• Caregivers must engage with the patient throughout the treatment process
• Care must be as accessible as possible
• All treatments must be clearly based on evidence
• Patients should have teams of care providers whenever possible
• Caregivers should strive for regular improvements in quality

Oncology Medical Homes seek to keep patients out of hospitals and in more affordable treatment centers. Combined with facilitating more efficient, effective care, this helps keep the cost of cancer treatment low, benefiting patients, insurers, and the entire healthcare system.

Bill Basics

Introduced by senators Tom Carper (D-DE) and John Cornyn (R-TX), the Cancer Care Payment Reform Act of 2017 seeks to encourage the use of the Oncology Medical Home model. To this end, it will create a National Oncology Medical Home Demonstration Project, which will compare the costs and effectiveness of different treatments and practices over the next five years. The bill changes how Medicare covers cancer care, favoring coordinated treatment programs that minimize their patients’ hospital and emergency room visits.

The Reform Act has the support of the Community Oncology Alliance, as well as that of leading oncologists throughout the country. Combined with its bipartisan origins and the widespread demand for more affordable, effective healthcare, this gives it a strong chance of passing.

For more information on the future of cancer care, contact us today.

The high cost of medication is causing breast cancer survivors to forego follow-up treatment.

For many breast cancer survivors, taking medication is an important part of their follow-up treatment, helping curb the production of the hormone estrogen or preventing the hormone from attaching to new cancer cells. But a new study from researchers at  The University of Texas Health Science Center at Houston has found as many as a third of women wind up going off their medications, despite the long-term benefits for their health. Why? The out-of-pocket costs are simply too high.

For their study, the researchers reviewed the medical records of nearly 8,700 women enrolled in Medicare Part D prescription drug plans between 2007 and 2009, comparing the number of women who continued to take their prescribed medications with the out-of-pocket costs associated with their therapies. What they found was that about 37% - more than a third - did not fill their medications routinely during the study period, with compliance the lowest among those whose out-of-pocket costs exceeded $10 per prescription. Compliance was also lower for single women living in poor communities compared to women who were married or living in more affluent neighborhoods. Rates of adherence were similar for black, white and Hispanic patients, the study authors noted.

Without these medications, many breast cancer survivors may be more prone to cancer recurrence or experience higher rates of cancer-related mortality, the researchers noted. The findings are especially important now that the Affordable Care Act (ACA) faces an uncertain future. The ACA offers subsidies that cover many out-of-pocket prescription costs, which means women who depend on ACA and Medicare may be more likely to face greater out-of-pocket costs in the near future.

Should counseling before genetic testing for breast cancer be required? This is the debate between insurers and healthcare providers.

What is Genetic Testing?

Genetic testing has become a way of alerting women of their heightened risk for breast cancer. They test for BRCA1 and BRCA2 - two genetic mutations associated with breast and ovarian cancer. Through the analysis of these tests, doctors are able to identify those who are likely to get the disease and be able to discuss preventative measures.

What is Genetic Counseling?

Genetic counseling is the process in which patients at high risk for an inherited disease are advised on the nature of their disorder. Certified Genetic Counselors hold a Master's of Science degree in genetic counseling and are expert educators, as well as highly skilled in translating "medical terms" into more easily understood language. They support patients and their families during the diagnosis and help with treatment options and decision making.

Healthcare Providers vs. Insurers

Healthcare providers believe that counseling should not be required before women have genetic testing done. It has long been a normal practice for obstetrician-gynecologists to counsel women of hereditary cancers and keep track of each individual's medical history. If they know a patient's biological family member had breast cancer, they would be capable enough to inform them of their high-risk for the disease.

Insurers, on the other hand, disagree. Two of which, large national insurers, UnitedHealthcare and Cigna require women to seek genetic counseling by a certified genetic counselor before approving tests. According to Dr. Jeffrey Hankoff, a Cigna official. “We had concerns that people were having testing ordered that didn’t appear to need it and probably didn’t understand it.” Thus, driving up supply and costs for unnecessary tests.

Should counseling before genetic testing be required?

In addition to insurers, genetic counselors believe so. They are the experts - why shouldn't they be the ones to gather the extensive family background information. Some of which may not be covered during routine paperwork. However, with the thriving request for genetic testing, keeping up with the demand could be trying.

In the end, both parties agree that it is of utmost importance to refer any woman with a family history of breast cancer for genetic testing. What they can’t seem to come to an agreement on is the steps leading up to it.