NCCS Supports Advance Care Planning as Part of Health Care Reform

The National Coalition for Cancer Survivorship (NCCS) today announced its support of the use of advance care planning as a best practice for quality care.

NCCS has long advocated for a system that encourages the practice of extended shared decision-making consultations between a physician and their patient —specifically in cancer at the start and finish of cancer treatment.  NCCS considers advance care planning to be one of several important episodes of care planning and an important vehicle to better position patients to be in control of their care. 

For many people with cancer who deal with the diagnosis as a chronic condition marked by episodes of illness and wellness, their needs will evolve and change throughout the course of their care—sometimes over many months, years, or decades.  NCCS believes that advance care planning  for people diagnosed with cancer would begin an important conversation with their physician that would ease their concerns about living as good a quality of life for as long as possible over the entire course of their illness. This conversation and subsequent advance care planning would put in place the patient's wishes for how they would want their care to be managed if their disease progresses and no longer responds to treatment. This, and all other shared decision-making and planning that respects a patient's wishes is, by definition, patient-centered care. 

"While it is likely to be uncomfortable for most people to talk about end-of-life care, a series of conversations about how we want to live out the rest of our life when cancer treatments have been exhausted are among the most important conversations we can have with our families and physicians," said Dr. Richard Payne, Chair-Elect, NCCS Board of Directors, Professor of Medicine and Divinity at the Institute on Care at the End of Life, Duke Divinity School. "We must seize the opportunity a diagnosis of cancer presents for these considerations."

The concept and practice of care planning for chronic and life-limiting illness emanates from a series of recommendations cited in several Institute of Medicine (IOM) reports on quality healthcare. NCCS regards care planning as a core component of quality care for people diagnosed with cancer, and a key priority for NCCS is to implement the use of care planning in clinical practice. Care plans for people with cancer are defined as patient-centered plans that are created at the beginning of treatment and include development of a treatment summary and follow-up care plan when cancer treatment is completed. Cancer care plans, by providing vital information about treatment options, symptom management, and coordination of care, would empower patients to make informed choices. The importance of advance care planning helps Medicare beneficiaries make well-informed treatment decisions regarding care across the continuum as well as at the end of life. 

NCCS urges our policymakers to support advance care planning and other reforms that would move Medicare and the entire health system toward a patient-centered delivery system. 

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