Cancer Care Experiences Among People Covered by Medicare

The Centers for Medicare & Medicaid Services’ Oncology Care Model (OCM) was a six-year voluntary initiative to improve cancer care delivery and patients’ experiences, while attempting to reduce costs. This report captures input from patient interviews and is a complement to the report on the model’s results. 

Most people who we interviewed were happy with the care they received. While some reported poor experiences, most said their caregivers communicated effectively, were responsive to their needs, and generally provided high-quality care. This mirrored patient survey responses collected during the evaluation. 

While more than half of interviewees wanted to actively participate in their treatment decisions, almost one-third said they felt most comfortable trusting their physicians to make decisions, and a small remainder didn’t agree with their prescribed treatment. This suggests oncologists can improve patient-centered care by acknowledging and responding to these different preferences in their practices. 

Overall, patients gave high marks when asked about access to care, but participants who live in rural areas or smaller towns may have to travel to receive care. These patients may have received their initial diagnosis after, say, surgery in the city, but it wasn’t always possible for them to return for every chemotherapy or radiation appointment. In those cases, they needed to rely on local providers and may have fewer choices for care.  

Results also underscored that a patient’s living situation may affect treatment. From living alone to serving as a caregiver for someone else, a person’s living situation may affect anything and everything from transportation to treatment decisions. Understanding such consideration may help cancer care teams tailor treatment to improve outcomes. 

Finally, the greatest challenge identified in the report was mental health support. Despite OCM’s requirement that cancer patients be screened for depression, patients found that care teams were less likely to address emotional problems—such as anxiety or depression—than other symptoms. It may be that broader efforts to improve mental health access throughout the health care system are needed to address this challenge.