The strategic case for establishing public-private partnerships in cancer care

Health Research Policy and Systems

Kathleen Dalton³  Donna O’Brien¹  Kristin Reiter²  Debra J. Holden³ 

[1] Strategic Visions in Healthcare, LLC, New York, NY, USA;Department of Health Policy and Management, The University of North Carolina, Chapel Hill 27599, NC, USA;RTI International, 3040 E Cornwallis Rd, Research Triangle Park 27709, NC, USA

关键词: Strategic case;    Program evaluation;    Partnerships;    Cancer care;   

Others  :  1229095
DOI  :  10.1186/s12961-015-0031-x

 received in 2015-03-03, accepted in 2015-09-17,  发布年份 2015

【 摘 要 】

Background

In 2007, the National Cancer Institute (NCI) launched the NCI Community Cancer Centers Program (NCCCP) as a public-private partnership with community hospitals with a goal of advancing cancer care and research. In order to leverage federal dollars in a time of limited resources, matching funds from each participating hospital were required. The purpose of this paper is to examine hospitals’ level of and rationale for co-investment in this partnership, and whether there is an association between hospitals’ co-investment and achievement of strategic goals.

Methods

Analysis using a comparative case study and micro-cost data was conducted as part of a comprehensive evaluation of the NCCCP pilot to determine the level of co-investment made in support of NCI’s goals. In-person or telephone interviews with key informants were conducted at 10 participating hospital and system sites during the first and final years of implementation. Micro-cost data were collected annually from each site from 2007 to 2010. Self-reported data from each awardee are presented on patient volume and physician counts, while secondary data are used to examine the local Medicare market share.

Results

The rationale expressed by interviewees for participation in a public-private partnership with NCI included expectations of increased market share, higher patient volumes, and enhanced opportunities for cancer physician recruitment as a result of affiliation with the NCI. On average, hospitals invested resources into the NCCCP at a level exceeding $3 for every $1 of federal funds. Six sites experienced a statistically significant change in their Medicare market share. Cancer patient volume increased by as much as one-third from Year 1 to Year 3 for eight of the sites. Nine sites reported an increase in key cancer physician recruitment.

Conclusions

Demonstrated investments in cancer care and research were associated with increases in cancer patient volume and perhaps in recruitment of key cancer physicians, but not in increased Medicare market share. Although the results reflect a small sample of hospitals, findings suggest that hospital executives believe there to be a strategic case for a public-private partnership as demonstrated through the NCCCP, which leveraged federal funds to support mutual goals for advancing cancer care and research.

【 授权许可】

   
2015 Holden et al.

【 参考文献 】

• [1]Kaluzny AD, O'Brien DM. Managing disruptive change in healthcare: lessons from a public-private partnership to advance cancer care research. New York, NY: Oxford University Press; 2015.
• [2]Mazzucato M. The entrepreneurial state: debunking public vs. private sector myths. Anthem Press, London; 2013.
• [3]Johnson MR, Clauser SB, Beveridge JM, O’Brien DM. Translating scientific advances into the community setting: the National Cancer Institute Community Cancer Centers Program pilot. Oncology Issues. 2009. http://www.strategicvisionsinhealthcare.com/wp-content/uploads/2012/03/CancerArticle-accc-pdf., accessed 10-1-2015.
• [4]O’Brien D, Kaluzny AD. The role of a public-private partnership: translating science to improve cancer care in the community. J Healthcare Management. 2014; 59(1):17-29.
• [5]Clauser SB, Johnson MR, O’Brien DM, Beveridge JM, Fennell ML, Kaluzny AD. Improving clinical research and cancer care delivery in community settings: evaluating the NCI community cancer centers program. Implement Sci. 2009; 4:63. BioMed Central Full Text
• [6]Leatherman S, Berwick D, Iles D, Lewin LS, Davidoff F, Nolan T et al.. The business case for quality: case studies and an analysis. Health Aff. 2003; 22(2):17-30.
• [7]Holler B, Forgione DA, Baisden CE, Abramson DA, Calhoon JH. Interactive financial decision support for clinical research trials. J Health Care Finance. 2011; 37(3):25-37.
• [8]Song PH, Reiter KL, Weiner BJ, Minasian L, McAlearney AS. The business case for provider participation in clinical trials research: an application to the National Cancer Institute’s community clinical oncology program. Health Care Manage Rev. 2013; 38(4):284-94.
• [9]Kleinmuntz CE, Kleinmuntz DN. A strategic approach to allocating capital in healthcare organizations. Healthc Financ Manage. 1999; 53(4):52-8.
• [10]Straley PF, Schuster TB. Evaluation criteria: a framework for decision making. Top Health Care Financ. 1992; 19(1):14-25.
• [11]Wheeler JR, Clement JP. Capital expenditure decisions and the role of the not-for-profit hospital: an application of a social goods model. Med Care Rev. 1990; 47(4):467-86.
• [12]Holden DJ, Treiman K, Arena LC, Tzeng JA, Green S, Adams E, et al. Integrated evaluation report: overall findings for NCI’s Community Cancer Centers Program Pilot. 2012. http://ncccp.cancer.gov/files/Integrated-Evaluation-Report.pdf. Accessed 26 Jul 2013.
• [13]St. Germaine, D, Denicoff, AM, Dimond, EP, Carrigan, A, Enos, RA, Gonzalez, MM, Wilkinson, K, Mathiason, MA, Duggan, B, Einolf, S, McCaskill-Stevens, W, Bryant, DM, Thompson, MA, Grubbs, SS, & Go, RS. Use of the National Cancer Institute Community Cancer Centers Program Screening and Accrual Log to Address Cancer Clinical Trials Accrual. J Onc Practice. 2014; 10(2). doi:10.1200/JOP.2013.001194.
• [14]Siegel RD, Castro KD, Eisenstein J, Stallings H, Hegedus PD, Bryant DM et al.. Quality improvement in the National Cancer Institute Community Cancer Centers Program: the quality oncology practice initiative experience. J Oncol Pract. 2015; 11(2):e247-54.
• [15]Dimond EP, St. Germain D, Nacpil LM, Zaren HA, Swanson SM, Minnick C et al.. Creating a culture of research in a community hospital: strategies and tools from the National Cancer Institute Community Cancer Centers Program. Clinical Trials. 2015; 12(3):246-56.
• [16]Fennell ML, Das IP, Clauser S, Petrelli N, Salner A. The organization of multidisciplinary care teams: modeling internal and external influences on cancer care quality. J Natl Cancer Inst Monogr. 2010; 40:72-80.
• [17]Friedman EL, Chawla N, Morris PT, Castro KM, Carrigan AC, Das IP, et al. Assessing the development of multidisciplinary care: experience of the National Cancer Institute Community Cancer Centers Program. J Oncol Pract. 2014. Ahead of print.
• [18]Abernethy AP, Locke SC. The relationship between participation in the National Cancer Institute’s Community Cancer Centers Program (NCCCP) and clinical trials activity. A special review as a part of the overall evaluation of the NCCCP. 2012. http://ncccp.cancer.gov/files/Clinical-Trials-Analysis-Report.pdf: Accessed 10-1-2015.
• [19]Halpern MT, Spain P, Holden DJ, Stewart A, McNamara EJ, Gay G et al.. Improving quality of cancer care at community hospitals: impact of the National Cancer Institute Community Cancer Centers Program Pilot. J Oncol Pract. 2013; 9(6):e298-304.
• [20]Dalton K, Holden DJ, Wright A, Kane H, Allaire BT. NCCCP economic evaluation: final report on the pilot program costs and the strategic case for participation. 2012. http://ncccp.cancer.gov/files/Economic-Evaluation-Report.pdf. Accessed 26 Jul 2013.
• [21]Subramanian S, Ekwueme DU, Gardner JG, Trogdon J. Developing and testing a cost-assessment tool for cancer screening programs. A J Prev Med. 2009; 37(3):242-7.
• [22]Subramanian S, Tangka F, Green J, Weir H, Michaud F. Economic assessment of central cancer registry operations. Part II: developing and testing a cost assessment tool. J Registry Manag. 2009; 36(2):47-52.
• [23]Miles MB, Huberman AM. Qualitative data analysis: an expanded sourcebook. 2nd ed. SAGE, Thousand Oaks, CA; 1994.
• [24]Portilla LM, Rohrbaugh ML. Leveraging public private partnerships to innovate under challenging budget times. Curr Top Med Chem. 2014; 14(3):326-9.