On quality of care, the health care reform law authorizes development of a strategy to develop and test measures to improve quality of care to reduce health care disparities. However, the society’s policy statement cautions that the strategy "must not further weaken the efforts of providers who are struggling to care for these patients in a strained resource environment unless the tools are provided for them to improve their quality."
For example, penalties for increased readmission rates should take into account the reduced social support and high rates of comorbidities found in impoverished patients, the group said. "ASCO recommends that quality improvement efforts be conducted in such a way that providers caring for underserved patients are not penalized."
Dr. Polite said that ASCO already is working with "a very resource-constrained public hospital" in an effort to help the hospital improve quality with its scant resources. "We get that quality’s important," he said, but "we also get that it’s hard for people who don’t have the resources."
Clinical Trials and Data Collection
The statement also calls for greater efforts to ensure access to clinical trials for racial, ethnic, and low-income groups. And it seeks more attention to issues surrounding the capture of data on race and ethnicity as they relate to cancer disparities.
Overall, when considering cancer care and outcome disparities, patients in specific vulnerable population groups suffer disproportionately, the policy statement observes.
"We have a fragmented system," Dr. Polite said. "Most people are able to get through it because they put a lot of the burden on themselves," but the most vulnerable don’t have the resources to do that, he added.
"If at the end of the day we were able to achieve seamless integration of care for cancer patients – diagnosis through survivorship – and also include a medical home, that would be a tremendous benefit for cancer patients," he said.
The authors indicated no potential conflicts of interest.