Cancer Care Transparency

In keeping with CHCF's move to provide information on medical procedures to make them more "shoppable" for consumers, we have turned our attention to cancer care.

November 2014

Transparency Efforts to Date

CHCF's Market and Policy Monitor Program presumes that the public reporting of reliable, objective information about cost and quality is essential to improving health care for Californians. Such transparency allows comparisons among physicians, hospitals, and other providers and promotes quality improvement. Public reporting may also help consumers make better-informed choices; encourage employers, insurers, and others to reward high-quality, cost-effective care; and assist California policymakers seeking to expand access to affordable health care.

The cornerstone of CHCF's public reporting and transparency work is a consumer website that shares quality of care information about hospitals, medical groups, and long term care providers. Recent efforts focus on conditions and procedures that are more "shoppable" — that is, where the patient actually has choices and the time to make those choices: joint replacement surgery and maternity care.

In keeping with CHCF's move to target our transparency efforts on more shoppable conditions and procedures, in 2010 we launched an initiative focused on cancer care.

Advancing Cancer Care Transparency

CHCF's goal is to work with strategic partners in California and the nation to advance the measurement and reporting of information about cancer care quality and costs. Our aim is to support projects that lead to public reporting at the levels of the health care system that are meaningful to patients, providers, and other key stakeholders (for example, cancer center, community practice) to encourage quality improvement and better decisionmaking.

We understand that the science of assessing the quality of cancer care is relatively young and presents many technical challenges. We seek to work with a variety of partners, starting with current science and data, and move thoughtfully using sound methodology to provide better information to all stakeholders — especially to patients and providers.

We have funded these projects to date:

Background & Landscape 

  • An environmental scan of cancer transparency efforts in California and nationally (December 2010).
  • CHCF Almanac report describing who gets cancer in California, who pays for treatment, what treatment costs, and what is known about the quality of care (June 2012).
  • An Institute of Medicine (IOM) report, co-funded with others, about the status of cancer care quality in the United States and a vision for moving forward.

Clinical Care

  • An interactive map and reports about geographic variation in breast and prostate cancer treatment using California state discharge data and cancer registry data (May 2013). This work is part of a larger project on medical variation in California encompassing a range of elective procedures.
  • Exploratory analytic work to determine the feasibility of publicly reporting the number of cancer procedures performed by hospital with the California Office of Statewide Health Planning and Development and Laurence Baker, PhD, of Stanford University (in progress). The focus is on cancer procedures for which there is an established link between the number of procedures performed and clinical outcomes.
  • Exploratory analytic work to determine the feasibility of measuring cancer care quality at the medical group level in California with the Integrated HealthCare Association, Truven Health Analytics, and the Cancer Prevention Institute of California (in progress).
  • A workgroup to examine the barriers and opportunities for leveraging the California Cancer Registry (CCR) in measuring and improving the quality of cancer care, led by Robert Hiatt, MD, PhD, at UCSF. The work culminated in a Sacramento briefing and a published issue brief (November 2014).

Patient Experience

  • Development of a Consumer Assessment of Healthcare Providers and Systems (CAHPS) patient experience of cancer care survey instrument, in conjunction with the National Cancer Institute (NCI) and the Agency for Healthcare Research and Quality (AHRQ) (in progress). CHCF is supporting field testing in California, and an assessment of the business case for the Cancer CAHPS survey in California.

Costs

  • A report on cancer care spending in California with Deborah Schrag, MD, MPH of the Dana Farber Cancer Institute (in progress).

For More Information

Contact Stephanie Teleki, PhD, CHCF senior program officer, with any questions.