Estimating Real Costs of Care for Different Cancers, Insurance Types

A report from the American Cancer Society Cancer Action Network (ACS CAN) estimated the total costs to patients associated with cancer diagnoses and treatment, based on their type of insurance.


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While cancer-associated medical costs approximated $88 billion in health care spending in 2014, costs are expected to continue to balloon in the coming years. Even among patients covered by multiple types of insurance policies, out-of-pocket expenditures still approximated $4 billion in 2014.

ACS CAN recently released The Costs of Cancer, a report that addresses patient concerns about the total expenditures associated with cancer diagnoses and treatment. Journal of Clinical Pathways spoke with Jennifer Singleterry, MA, senior policy analyst with ACS CAN (Washington, DC), about the report’s findings, and the wide-ranging implications for cancer care and the associated costs in relation to health care and insurance reform.

In many cases, predicting total costs of cancer treatment is challenging for patients, especially because out-of-network care can be difficult to avoid and health insurance plans may deny preferred treatment.

ACS CAN worked with Avalere Health to estimate cancer care costs for three types of disease – breast, lung, and colorectal. Researchers then applied those costs through three common insurance designations: employer-sponsored insurance, Medicare, and the individual marketplace. Results of this application yielded a model cost-breakdown for patients with these cancer types and these insurance designations.

Dr Singleterry stressed that patients with cancer need to be aware of the premiums and out-of-pocket expenses when choosing an insurance plan.

Furthermore, Dr Singleterry expressed her belief that clinical pathways may be helpful in this decision-making process. “It is certainly something we are exploring,” she explained.

Read the full interview with Dr Singleterry.—Zachary Bessette