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Barriers to the optimal rehabilitation of surgical cancer patients in the managed care environment: An administrator's perspective
Author(s) -
Germain Pamela
Publication year - 2007
Publication title -
journal of surgical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.201
H-Index - 111
eISSN - 1096-9098
pISSN - 0022-4790
DOI - 10.1002/jso.20781
Subject(s) - rehabilitation , medicine , managed care , health care , payment , cancer , ambulatory care , nursing , perspective (graphical) , health care delivery , family medicine , physical therapy , business , finance , artificial intelligence , computer science , economics , economic growth
Ensuring that surgical cancer patients obtain optimal rehabilitation care (defined here as all care provided post‐operatively following cancer surgery) can be challenging because of the fragmented nature of the U.S. healthcare delivery and payment systems. In the managed care environment, surgical cancer patients' access to rehabilitation care is likely to vary by type of health insurance plan, by setting, by type of provider, and by whether care is provided in‐network or out‐of‐network. The author of this article, who negotiates managed care contracts for the Roswell Park Cancer Institute (RPCI), gives examples of strategies used with some success by RPCI to collaborate with local payers to ensure that surgical cancer patients get optimal rehabilitation care, especially as they make the transition from hospital to outpatient care. She suggests that further collaborations of healthcare providers, payers, consumers, and policymakers are needed to help ensure optimal rehabilitation care for surgical cancer patients. J. Surg. Oncol. 95:386–392. © 2007 Wiley‐Liss, Inc.