Late-Stage Cancer Care

In addition to premature death, patients with late-stage cancer suffer considerable disability and pain. The annual cost of cancer care in the United States was $150.8 billion in 2018 and is expected to increase to $157.7 billion by 2020 — a rate that outpaces the projected growth of overall medical expenditures. Much of these expenditures are expected to occur for late-stage cancers, which generally have very poor prognoses.

Projects and Outcomes

CERC’s care redesign team developed a new Care Model with three core elements: 

  1. Assist patients and their caregivers with better formulating their goals for care and selecting treatment options that will better meet these goals.

  2. Offer immediate treatment of pain and other symptoms associated with late-stage cancer at home through a 24/7 call center staffed by nurses specializing in cancer care; this approach uses symptom treatment algorithms and pre-placed emergency medication packets in patients’ homes.

  3. Provide chemotherapy mostly in the patient’s home, or in safe, economical sites closer to patients’ homes.

Pilots to examine cost and quality were initially launched at Palo Alto Veterans Administration Hospital and CareMore Health in Los Angeles. Results in 2018 and 2019 showed a favorable impact on quality of care measures, a 90% cost reduction in the last month of life, and a 20% cost reduction in monthly per capita total healthcare spending. In 2019, The Pacific Business Group on Health obtained seed funding from the State of California for statewide scaling.

Publications and News