Barriers to the optimal rehabilitation of surgical cancer patients in the managed care environment: an administrator's perspective.
Ensuring that surgical cancer patients obtain optimal rehabilitation care (defined here as all care provided post-operatively following cancer surgery) can be challenging because of the fragmented nature of the U.S. healthcare delivery and payment systems. In the managed care environment, surgical cancer patients' access to rehabilitation care is likely to vary by type of health insurance plan, by setting, by type of provider, and by whether care is provided in-network or out-of-network. The author of this article, who negotiates managed care contracts for the Roswell Park Cancer Institute (RPCI), gives examples of strategies used with some success by RPCI to collaborate with local payers to ensure that surgical cancer patients get optimal rehabilitation care, especially as they make the transition from hospital to outpatient care. She suggests that further collaborations of healthcare providers, payers, consumers, and policymakers are needed to help ensure optimal rehabilitation care for surgical cancer patients.
Germain
Pamela
P
Managed Care & Outreach, Roswell Park Cancer Institute (RPCI), Elm & Carlton Streets, Buffalo, New York 14263, USA. Pamela.germain@roswellpark.org
D001943:Breast Neoplasms / Q000175:diagnosis / Q000191:economics; D032982:Contracts; D003695:Delivery of Health Care / Q000639:trends; D005260:Female; D017048:Health Care Costs; D018718:Home Infusion Therapy; D006801:Humans; D007348:Insurance, Health; D008329:Managed Care Programs / Q000458:organization & administration*; D017008:Negotiating; D009369:Neoplasms / Q000534:rehabilitation*; D011182:Postoperative Care / Q000534:rehabilitation*; D011787:Quality of Health Care; D013514:Surgical Procedures, Operative / Q000534:rehabilitation*