Narrow networks top barrier to cancer-care referrals

Sixty percent of physicians have difficulty referring their patients for appropriate cancer care, with such challenges correlating significantly with decreased professional satisfaction, according to a study published in Cancer.

For the study, Daniel H. Kwon, from the David Geffen School of Medicine at the University of California in Los Angeles, and colleagues analyzed responses of 1,562 primary care physicians and 2,144 specialists to the multiregional Cancer Care Outcomes Research and Surveillance Consortium physician survey.

Three out of five respondents reported that they always, usually or sometimes encountered at least one barrier to referring cancer patients for more specialized care, yet the frequency varied by type of barrier. The most common challenges physicians face in referring patients for cancer care, from most to least frequent, include the following:

  • Restricted provider networks (42 percent)
  • Preauthorization requirements (34 percent)
  • Patients' inability to pay (34 percent)
  • Excessive patient travel time (28 percent)
  • Lack of surgical subspecialists (13 percent)

Consistent with previous studies, yet contradictory to the rankings above, physicians with large proportions of their patients in managed care plans had fewer barriers overall. Researchers theorized that such physicians may practice in integrated settings with streamlined referral systems, in-network specialists and insured patients.

However, researchers also found that physicians in solo or small practices were more likely to report barriers to specialist referral than those in hospital-based or larger practices. They recommended further research on these findings as well as the impact of patient-centered medical homes and other developing payment models on referrals.

To learn more:
- read the study