patients are on treatment plans for which there is no supporting medical evidence or defini- tive research. UAB is a founding member of the National Comprehensive Care Network, which has spent decades developing evidence-based treat- ment plans for cancer patients. Mr. Smedley points to a non-small cell lung cancer study that showed that patients on an evidence-based clinical path- way cost 35 percent less for their total episode of care than patients who did not adhere closely to clinical pathway. Their outcomes were the same or even better. Reducing chemotherapy in the last two
weeks of life. Medicare has reported that as much as 20 percent of its cancer patients receive therapeutic chemotherapy within the last two weeks of the patients life. There is such a thing as palliative chemotherapy that could be given in certain circumstances to ease pain and increase comfort, Mr. Smedley says. Therapeutic chemo- therapy, however, is aimed at curing the cancer. If you only have two weeks left to live, then it makes you much sicker, and it s not going to cure the can- cer. Most physicians know when they ve exhausted all the standard therapies, and all they re doing is trying to give the patient a little bit of hope. But it s making them really sick, and it costs a lot of money to do it. Moving patients to hospice care earlier. Another study quantified the amount of money saved daily per patient by getting them into hos- pice sooner instead of waiting until the end of life. Diseases such as lung cancer, which sees only 13 percent of patients alive after five years, still are extremely difficulty to treat. Patients facing a
difficult diagnosis should be told about the ben- efits of palliative hospice care early and should be encouraged to move in that direction if their disease develops into an advanced stage. The research clearly shows that palliative and hospice care improve patients well-being, lengthen their average life expectancy and are much more cost- effective, Mr. Smedley says.
Applying these interventions to the Cancer Center s and its affiliates patient populations pres- ents a potential savings of $49 million over three years. An initial outlay of only $15 million means a return on investment of more than 300 percent. We know this program presents tremendous potential to improve the way cancer services are managed, and we are excited to have the opportu- nity to make it happen, Mr. Smedley says.
We determined that if
we were able to reduce
hospital utilization by 9.5
percent across the whole
group, over a three-
year period we would
save approximately $23
million. Warren Smedley, M.S.H.A.
U A B C O M P R E H E N S I V E C A N C E R C E N T E R 5
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