The costs of cancer care are expected to grow from $72 billion in 2004 to $173 billion by 2020.1 Unfortunately, the fee-for-service Medicare reimbursement model provides financial incentives for administering chemotherapy even in the last weeks of life, another day in the intensive care unit (ICU), and recurrent hospitalizations and disincentivizes having conversations that educate patients diagnosed as having cancer and their families about their prognosis and treatment options and developing a care plan consistent with patients’ informed goals of care. These incentives are important, but do not wholly determine the quality of care that patients receive. However, a 2013 Institute of Medicine Report2 concluded that our cancer care system is in crisis, stating that “cancer care is often not as patient-centered, accessible, coordinated, or evidence-based as it could be.”
Teno JM, Curtis JR. Family Perspectives on Aggressive Cancer Care Near the End of Life. JAMA Oncol. 2016;2(7):957–958. doi:10.1001/jamaoncol.2016.0441
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