CHCF strongly believes that the public reporting of reliable, objective information about quality and cost is essential to making health care work for all Californians. Such transparency helps inform decisionmaking by patients and their families. It promotes quality improvement by informing providers about how they are doing, and by encouraging payers to reward high-quality, cost-effective care. And it gives California policymakers the information they need to expand access to affordable health care. Given the importance of cancer and the significant lack of data about cancer care quality and costs, CHCF launched an initiative in 2009 to improve the transparency of cancer care.

Since then, CHCF has funded projects in California and the nation to better measure and report information about cancer care quality and costs. Our aim has been to improve public reporting at the levels of the health care system that are meaningful to patients, providers, and other key stakeholders.

We understand that the science of assessing the quality of cancer care is relatively young and presents many technical challenges. We have sought to work with a variety of partners to benefit from the best knowledge available. We started with what was the most current science and data at the time, and moved thoughtfully, using sound methodology to provide better information. See the complete list of projects to date below.

For More Information

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

CHCF Projects to Date to Advance Transparency in Cancer Care

Background & Landscape

• An environmental scan of cancer transparency efforts in California and nationally (December 2010).
• A 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, cofounded with others, about the status of cancer care quality in the United States and a vision for moving forward (October 2013).
• A Sacramento briefing on the state of information about cancer care quality in California and possible paths to improve the status quo (October 2013).

Clinical Care

• 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.
• Public reporting of the number of cancer surgeries performed by hospital with the California Office of Statewide Health Planning and Development and Laurence Baker of Stanford University (November 2015). 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 at UCSF. The work culminated in a Sacramento briefing and a published issue brief (November 2014).
• A white paper from the Integrated Healthcare Association (PDF) demonstrating how state cancer registry data can be combined with commercial claims and encounter data to measure cancer care quality statewide, regionally, and for physician organizations. The report offers suggestions for improving data linkages and timeliness, expanding allowable uses of data, and streamlining the data access process (November 2016).

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 of the Dana Farber Cancer Institute (August 2015).