ABSTRACT
BACKGROUND: A multidisciplinary panel representing various stakeholders in the health care delivery and oncology services marketplace was convened to develop specific criteria for healthcare purchasers to consider when evaluating the structures and processes of health plans. These rank ordered criteria also can be used by oncologic service providers and health plan designers as a yardstick for the services they offer. METHODS: A multidisciplinary 31-member Task Force was assembled by the Kerr L. White Institute and the American Cancer Society in March 1997. Task Force members were selected for their ability to offer expert insight as purchasers, suppliers, policymakers, consumers, or stakeholders in the health care marketplace. A preference-weighted majority voting rule was used to identify the three most important recommendations of the 10 that were generated through a modified Delphi technique. To test the practicality of the top three recommendations, leaders of large managed care organizations (MCOs) were surveyed; the results of this survey then were compared with the results of the Task Force survey. RESULTS: The three most important recommendations from the Task Force were that health plans provide access to: 1) comprehensive cancer care, 2) preventive and screening services, and 3) second opinions and treatment options supported by scientific evidence. The difference between the responses of the Task Force and the MCOs was that MCOs placed the highest importance on evidence-based decision-making, with their next three rankings coinciding with those identified by the Task Force. CONCLUSIONS: The value of these summary recommendations will be realized through their use by both purchasers and suppliers to influence the structure and content of the delivery of oncologic services.
Subject(s)
Delivery of Health Care/economics , Group Purchasing , Managed Care Programs/economics , Marketing of Health Services , Medical Oncology/economics , Costs and Cost Analysis , Decision Making , Delphi Technique , Guidelines as Topic , Health Care Costs , Health Care Sector , Health Care Surveys , HumansABSTRACT
In 1989, the American Cancer Society funded three Community Cancer Detection, Education and Prevention Demonstrations Projects for socioeconomically disadvantaged populations in Miami, Harlem, and West Oakland. Each project has demonstrated that by using a multifunction, multisite cancer control model with an action theory that integrates individual and structural influences, many barriers to screening and follow-up can be minimized.