ACA is Limiting Patient Access to Cancer Centers

YOU ARE HERE: HOME / MARKET INTELLIGENCE / ACA IS LIMITING PATIENT ACCESS TO CANCER CENTERS ACA is Limiting Patient Access to Cancer CentersSome of America’s best cancer hospitals are off-limits to many of the people now signing up for coverage under the nation’s new health care program, according to a recent story in the Washington Post.

An Associated Press survey found examples coast to coast. Seattle Cancer Care Alliance is excluded by five out of eight insurers in Washington’s insurance exchange. MD Anderson Cancer Center says it’s in less than half of the plans in the Houston area. Memorial Sloan-Kettering is included by two of nine insurers in New York City and has out-of-network agreements with two more.

In all, only four of 19 nationally recognized comprehensive cancer centers that responded to AP’s survey said patients have access through all the insurance companies in their states’ exchanges.

The AP surveyed 23 institutions around the country that are part of the National Comprehensive Cancer Network. Two additional institutions that joined this week were not included in the survey.

AP asked the centers how many insurance companies in their state’s exchange included them as a network provider.

Of the 19 that responded, four reported access through all insurers: the Kimmel Comprehensive Cancer Center at Johns Hopkins in Baltimore, Fox Chase Cancer Center in Philadelphia, Duke Cancer Institute in Durham, N.C., and Vanderbilt-Ingram Cancer Center in Nashville. One caveat: Some insurers did not include these cancer centers on certain low-cost plans.

Two centers had special circumstances. The best known is St. Jude’s Children’s Research Hospital in Memphis. Treatment there is free as long as children have a referral.

For the remaining 13, the gaps were evident.

The overall incidence of cancer in the United States is projected to increase by 45% in the next two decades from 1.6 million in 2010 to 2.3 million in 2030.

Direct medical costs associated with cancer are also projected to increase exponentially from $104 billion in 2006 to more than $173 billion in 2020 as a result of increases in both the cost and quantity of cancer therapies.