Cancer Manager - Opening the Door to Quality Cancer Care

 

Dr. Martin N. Raber (seated) discusses collaborative care pathways and practice guidelines with Dr. David L. Callender (right) and Dr. Spencer Berthelsen of Kelsey-Seybold.

 

 

Today, taking an aggressive, competitive stance in the changing managed care marketplace means assuming risk for patients and managing delivery of care throughout the entire disease process.

 

A cornerstone of M. D. Anderson's managed care strategy is Cancer Manager, a network of oncology services that provides a customized continuum of care from prevention and diagnosis to treatment and followup.

 

This seamless care system can lower overall costs for cancer care and provide better patient outcomes, says Dr. Martin N. Raber, vice president for managed care and outreach programs. It also allows the cancer center's oncologists to be the sole "gatekeepers" for each patient's care.

 

Cancer Manager is M. D. Anderson's response to growing national and local trends in managed care. According to Dr. Raber, self-insured employers and large managed care payors now want to purchase services directly from health care providers in an effort to eliminate administrative costs.

 

In addition, employers, employees and patient advocacy groups are demanding better access to quality health care centers, improved outcomes and more efficient coordination of care. In answer to these requests, more centers like M. D. Anderson and physician groups are accepting the risk for these large groups, and developing products and systems for lowering costs and managing disease.

 

Managed care is ever-present in today's health care environment, and its growth is apparent in the cancer center's patient portfolio. The percentage of insured patients coming to the center under managed care contracts has almost doubled since 1994, with about 48 percent representation in 1997.

 

Though Cancer Manager was unveiled in 1996, the program and its infrastructure were further refined over the past fiscal year in preparation for aggressive marketing. Randalls Food Stores, with more than 24,000 employees, was the first to sign up with the program. OneCare, which insures approximately 30,000 individuals, was next to enroll.

 

During the year, Kelsey-Seybold - a major independent physician practice association with approximately 167,000 patients in Houston and the surrounding area - signed up for specific services. M. D. Anderson now provides all second opinions for Kelsey-Seybold patients who have a questionable lump. Negotiations with other organizations are well under way.

 

A structured, yet flexible system, Cancer Manager utilizes the cancer center's unique skills in the treatment of the cancer patient and management of their disease. Providing the quality as well as cost controls for Cancer Manager are computerized information systems that detail M. D. Anderson's collaborative care pathways and practice guidelines. These tools help map the optimal course of treatment and aid in forecasting and controlling costs.

 

Tied into these pathways and guidelines are affiliates of M. D. Anderson's Physicians Network and a number of other community physicians. For patients whose disease is less complex or those who wish to get treatment closer to home, Cancer Manager allows them to receive the M. D. Anderson quality of care without having to come to the Texas Medical Center.

 

"M. D. Anderson has proven itself to be a leader in quality cancer care and now, as Cancer Manager grows and takes hold in the marketplace, we will show that we know how to manage cancer care - not just provide it," Dr. Raber says.

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