Rural Communities Face Barriers to Cancer Care, but Approaches Exist to Improve Outcomes

January 7, 2020

ASCO recently submitted comments to the House Committee on Ways and Means and the House Rural and Underserved Communities Health Task Force in response to a request for information (RFI) on priority topics that affect the health status and outcomes for rural and underserved communities.

“Nearly one in five Americans (over 59 million) live in rural areas,” ASCO President Howard A. “Skip” Burris III, MD, FACP, FASCO, wrote in the comment letter.  “Cancer patients living in rural areas of the United States are diagnosed at later stages, have a higher proportion of their cases unstaged at diagnosis, and are often in a more advanced stage of illness when referred to home health agencies.”

In its comments, ASCO called attention to some of the barriers that prevent patients with cancer from receiving timely access to high-quality cancer care. Barriers include transportation, insurance coverage and access to clinical trials, the sustainability of oncology practices in rural settings, oncology workforce shortages, and data collection.

ASCO put forth several legislative solutions that would enable the United States to begin to close gaps and improve access and outcomes for patients with cancer in rural areas. ASCO noted that Congress should:

  • Pass the CLINICAL TREATMENT Act (H.R. 913), which would guarantee Medicaid coverage of the routine care costs for clinical trial participation.
  • Address the impact of utilization management practices on patients with cancer and their cancer care teams by passing the Improving Seniors’ Timely Access to Care Act (H.R. 3107), which would help to alleviate burdens and delays created by prior authorization within Medicare Advantage plans, and the Safe Step Act (H.R. 2279), which would put create important guardrails to protect patients from barriers caused by step therapy protocols.
  • Pass the Cancer Drug Party Act (H.R. 1730), which would ensure that patient cost sharing for oral anticancer drugs is no less favorable than for IV anticancer drugs.

ASCO continues to work on other solutions to improve access to cancer care in rural communities and recently launched its Rural Cancer Care Task Force aimed at reducing disparities and improving outcomes for patients and survivors living in rural communities. ASCO also held an event, “State of Cancer Care in America: Closing the Rural Cancer Care Gap,” to call attention to these issues and explore options to improve care and outcomes.

Read ASCO’s full comments.

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