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Fred Hutch issues report on cancer care in Washington state

Report provides snapshot of cancer-clinic performance based on quality and cost; finds room for improvement in emergency room visits and end-of-life care
Dr. Veena Shankaran is co-director of the Hutchinson Institute for Cancer Outcomes Research, Fred Hutch's healthcare economics research group.
Dr. Veena Shankaran is co-director of the Hutchinson Institute for Cancer Outcomes Research, Fred Hutch's healthcare economics research group. Robert Hood / Fred Hutch

SEATTLE — Oct 24, 2019 — Fred Hutchinson Cancer Research Center released its second annual report linking quality and cost of cancer care at clinics in Washington state, the Community Cancer Care in Washington State: Quality and Cost Report 2019. The report was led by the Hutchinson Institute for Cancer Outcomes Research, or HICOR, a research group at Fred Hutch whose mission is to improve cancer care in ways the will reduce the economic and human burden of cancer. It is the only such study in the nation to publicly report clinic-level cancer quality measures linked to cost.

The 2019 report measured performance in four areas for 29 clinics across Washington state:

  • Adherence to treatment recommendations for breast, colorectal and lung cancer.
  • Emergency department visits and inpatient hospitalizations during chemotherapy.
  • Tumor marker testing following treatment for breast cancer.
  • Appropriate end-of-life care.

While the report found quality to be relatively consistent from one clinic to another, costs varied. In some performance areas, there was a strong relationship between higher quality and lower cost, indicating that improvements in quality can also reduce costs. The report also shows that there is room for improvement in two areas:

  • Reducing emergency department visits and hospitalizations during chemotherapy.
  • Providing appropriate end-of-life care, such as avoiding emergency department visits, hospital stays and chemotherapy at the end of life.

“As cancer care costs continue to escalate, finding effective ways to improve quality and simultaneously reduce costs is an ongoing dilemma,” said Dr. Veena Shankaran, co-director of HICOR. “We believe that publicly releasing information about quality and cost is a critical step toward meaningfully improving quality while addressing the rising costs of cancer care. We could not have done so without the involvement and commitment to this effort from patients, clinics and payers.”

Through a six-year collaboration among patient partners, hospitals and clinics delivering cancer care, health insurance plan administrators, researchers, health quality organizations, policymakers, and government leaders in Washington state, the HICOR team developed the report’s four performance areas. HICOR’s database combines information from the Washington State Cancer Registry and the Western Washington Cancer Surveillance System with health utilization and cost data from public and private health insurers in the state.

“We’re proud to lead the nation in measuring cost and quality in cancer care,” said Shankaran. “Our hope is that this report and the methodologies used may serve as a valuable resource for other states as they too grapple with these important issues.”

Many Washington state clinics have used the 2018 report to launch quality improvement programs. Most cancer patients are treated in community clinics, so publicly reporting clinic-level outcomes provides clinics opportunities to improve care and share best practices. In the report, clinics can see areas where they excel and areas where there may be room for improvement. The report is not intended to provide side-by-side comparisons or guide individual patient’s decisions. Rather, the goal of the report is to share information to improve care so that every cancer patient in Washington state will have access to high-quality, affordable care no matter where they are treated.

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At Fred Hutchinson Cancer Research Center, home to three Nobel laureates, interdisciplinary teams of world-renowned scientists seek new and innovative ways to prevent, diagnose and treat cancer, HIV/AIDS and other life-threatening diseases. Fred Hutch’s pioneering work in bone marrow transplantation led to the development of immunotherapy, which harnesses the power of the immune system to treat cancer. An independent, nonprofit research institute based in Seattle, Fred Hutch houses the nation’s first National Cancer Institute-funded cancer prevention research program, as well as the clinical coordinating center of the Women’s Health Initiative and the international headquarters of the HIV Vaccine Trials Network.

Media contact:
Claire Hudson                         
O: 206.667.7365
C: 206.919.8300



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