Summary

For the millions around the world living with cancer, recent treatment breakthroughs have delivered new hope.

01
February
2019
|
06:10 PM
America/New_York

Progress Equals Lives Saved: How Horizon Is Advancing Cancer Care in New Jersey

By Thomas Graf, MD, Vice President and Chief Medical Officer


For the millions around the world living with cancer, recent treatment breakthroughs have delivered new hope. Since peaking in 1991, the death rate from cancer in the United States has declined 27 percent. And yet, more still needs to be done. An estimated 16,000 people will die in New Jersey from cancer in 2019, according to the American Cancer Society.

On February 4, Horizon Blue Cross Blue Shield of New Jersey joins in observing World Cancer Day to raise awareness around the progress that’s been made and the distance that still needs to be traveled. But, our commitment extends far beyond a single day. We work with providers, community partners, patients and caregivers every day to make a difference for those living with cancer in New Jersey. Here’s just some of the many ways we’re advancing innovative cancer care in the state:

Helping to catch cancer early

According to the Union for International Cancer Control, the organization behind World Cancer Day, more than one third of cancer cases can be prevented. Another third can be cured if detected early and treated properly. That’s why Horizon BCBSNJ has invested in a wide range of screening and prevention programs.

Through our partnership with the American Cancer Society, we co-sponsor statewide educational events, distribute materials and engage individuals to bring awareness to our screening programs and encourage participation. We have also collaborated with ScreenNJ to increase colorectal cancer screenings by participating in an educational screening forum and sponsoring a webinar for our Medicaid and value-based providers on colorectal cancer screening.

Making care more accessible is also a priority. That’s why we reward doctors and hospitals for increasing screening among their patients. In 2017, the providers who participate in Horizon’s “value-based” programs achieved a 6 percent higher rate for colorectal cancer screenings and a 7 percent higher rate for breast cancer screenings than traditional providers. When these doctors and hospitals achieve mutually agreed-upon quality goals, they earn additional compensation.

And, when guidelines call for it, we make reminder phone calls to our members for a screening appointment. In the future, we’ll send out digital reminders, including texts.

Moving cancer care forward with research

Breakthroughs usually start after investments in research. Horizon BCBSNJ isn’t waiting passively for evidence to surface on the effectiveness of new medical innovations; we’re investing with partners to create it.

  • Expanding therapies to more cancers. Traditional radiation therapies remain an effective way to kill cancer cells and shrink tumors. Now, scientists have developed new ways to harness the power of radiation while also limiting side effects. One of these approaches is called proton beam therapy. We’re partnering with Rutgers Cancer Institute of New Jersey, Robert Wood Johnson University Hospital, and UPenn Medicine to enroll patients in proton beam clinical trials for brain, breast and prostate cancers. By helping support new evidence-based treatments, we will ultimately give members more options backed by science to control their cancer.
  • Detecting breast cancer early: Breast cancer is the second leading cause of cancer-related death in New Jersey. We are covering the cost for 5,000 Horizon BCBSNJ members to participate in the WISDOM (Women Informed to Screen Depending on Measures of Risk) study. This five-year study seeks to clarify the safest, most effective screening method for women to help end the confusion around when and how often to get a mammogram.

The right treatment for the right patient

There are more than 200 types of cancer. Years ago, doctors would generally treat them based on body location – for example, the lung or the breast. Today, doctors can target these cancers much more precisely using genomic testing or analyzing molecular markers on a tumor.The result? Doctors can match the right treatment to an individual patient. But there is still a lot of confusion for patients. Navigating complex landscape of providers and therapies acts as a barrier for timely, effective care.

Horizon BCBSNJ is working both to increase clarity and reduce confusion:

  • Helping doctors make better treatment decisions. By knowing what treatments have worked best for a specific type of cancer, doctors can make the most informed choices for their patients. We have invested in COTA, a software platform that groups together patients with similar cancers based on their molecular profiles and then compares how effective particular therapies have been in treating those diseases.
  • Connecting patients to the right care. In partnership with doctors and health care systems across the state, our Oncology Medical Home program helps coordinate and  improve the care our members get. Registered nurses and social workers not only make sure patients find the right doctors, get to their appointments, and coordinate treatments, but also connect these members to the emotional, financial and community support they need to recover.
  • Increasing quality, not costs: For all types of treatment, our goal is to deliver better care, which can be different than just more care. That’s why we’ve created programs that give doctors new tools that improve treatment protocols and outcomes for our members.By avoiding tests or treatments that don’t help fight or eliminate cancer, patients are spared the physical and emotional tolls that sometimes accompany cancer treatments -- not to mention unnecessary costs. In these programs, the treatment decisions are always made by the doctor, not the insurer. And when quality goals are met, doctors can share in any cost savings. This innovative payment model has been developed for breast, lung, colorectal and prostate cancers.

Horizon BCBSNJ is committed to helping transform cancer care, looking for new partnerships and investments to get us closer to a cancer-free world. Our goal is to enable the best possible health for each of our members. We can do this when we reliably deliver care that’s measurably better in areas that matter to both physicians and patients, And with cancer, the stakes couldn’t be higher, because the more progress we make, the more lives we can save.