Introduction
Patient-focused care is an operational paradigm that addresses the inherent and structural elements of hospital costs. Resources are moved closer to the patient. To enhance service levels and improve continuity of care, personnel are cross-trained to ensure that routine patient needs can be met quickly and effectively.
The rapid evolution of managed care in many health care markets is driving the reevaluation of the traditional institution-based cancer care program paradigm. For the past twenty years, community hospitals, academic hospitals, and medical centers have focused on developing and refining the multidisciplinary hospital-based cancer program. However, the restructuring of the health care system in response to the competition for patients controlled by managed care organizations creates the need for new paradigms of providing cancer care. One strategy is the development of physician oncology networks that manage cancer care and compete for captivated contracts in a geographically defined health care market.
Recent Trends
Currently, in most health care markets, for-profit managed care corporations are focused on obtaining health care services at as low a cost as possible while providing as large a profit as possible to satisfy their investors. To control costs, these corporations carefully control patient access to services by means of primary care physician gatekeepers, precertification of tests and hospitalizations, review of treatments using guidelines derived from insurance companies, and refusal to fund patient care costs associated with clinical trials.
Patients in strictly managed plans may not have access to the specialists or cancer program they would choose in their community. Access of patients to advanced technology or clinical trials may be severely limited based on cost rather than patient benefits.
Body of Paper
In the managed care environment, physicians have had to add office staff to handle the additional "red tape" required to care for their patients....
