When it comes to cancer surgery outcomes, volume counts

A new study encourages insurers to stop paying for cancer surgeries at hospitals where they're rarely done.
A new study encourages insurers to stop paying for cancer surgeries at hospitals where they're rarely done.
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Patients who have cancer surgeries at hospitals that perform them infrequently are more likely to have complications, according to a study by the California Health Care Foundation.

The study examined 2015 data on 11 types of cancer surgeries at California hospitals. It found that 72 percent of the state's hospitals performed only one or two surgeries for certain types of cancer that year, and that, it says, can prove dangerous for patients.

"Mortality and complications are much more highly associated with low-volume centers," says study co-author MaryAnn O’Sullivan. "Experience counts. It counts a lot."

The authors encourage consumers to ask about the experience level of not just their surgeon, but the hospital as a whole. In addition, they suggest looking online for information from the health insurer and comparison websites.

The report also found nearly half of the patients who had surgeries at hospitals that rarely performed their operations could have traveled less than 20 miles to a hospital where the surgery is more commonly performed. Three-quarters of them were within a 50-mile drive.

There’s no guarantee, however, that a patient’s health plan will cover surgery at another hospital.

The study recommends that insurers stop paying for cancer surgery at the low-volume hospitals, but again, that raises the question of whether the insurer's provider network includes nearby hospitals.

Insurance companies take hospital performance into consideration when they create their networks, says Charles Bacchi, CEO of the California Association of Health Plans. He points out that it saves insurers money in the long run if patients receive higher quality care.

"Plans are constantly looking at [outcomes] and so are our purchasers, like Covered California, CalPERS, and other large employers," he says. "[They're] really pushing us, as plans, to help them sort through who the best providers are."

The American Cancer Society estimates 173,000 people were diagnosed in the U.S. with cancer in 2016.