Insights on Oncology Care Management

About 2 years ago, I had the good fortune to meet leaders at UAB’s Comprehensive Cancer Center. At the time, I knew that care management processes like ours worked for Type 2 Diabetes, but I never thought they would for cancer. Imagine my surprise when I learned of UAB’s CMMI Lay Navigator initiative and understood that not only do they apply, they are really very similar.

It turns out that both people with diabetes and people with cancer need help changing habits, improving lifestyles, eating healthy, exercising, and navigating the healthcare system. At Pack Health, we have implemented a program to support individuals with cancer, which is aligned to the goals of the Oncology Care Model (OCM) as well as those of the Commission on Cancer. For those interested in care management for cancer patients, we wanted to share insights from being on the (relative) front lines of this movement.

For the first installment, we’ll start at the same place we start with our members: Motivation. Studies show that positive, intrinsic motivation predicts better outcomes, but what motivates cancer patients through their treatment journey?

The top motivators for patients opting into a care management program

Top 5 Motivations

We looked at the primary motivators for improving health in our population with cancer. “Family” rose to the top by a clear margin (see chart).

What is interesting is that most people do not have such a clear positive, intrinsic motivation. Negative (e.g., fear of death), extrinsic (e.g., bills) motivators are too often the driving forces of daily lives. When cancer strikes, however, those patients opting into a care management program such as ours are those that have found motivation in the people they love (as well as other goals such as living longer). This insight may be useful for those trying to drive engagement in OCM models.

Motivated patients get more motivated in a care management program

Statistically, when we compare measures over a 3 month period, we see that motivation increases over time with our population (baseline mean = 4.30 vs follow-up mean = 4.63, p = .001). In other words, our members become more motivated in their fight against cancer following intensive engagement with a Health Advisor (and likely any other effective care management process).

Takeaway: help patients find their motivation for a better OCM outcome

While there are many potential conclusions to draw here, and this is certainly not a pure statistical analysis, it does suggest that to drive engagement in care management processes, Health System leaders should help patients identify their positive, intrinsic motivations first. Doing so may feel soft or unscientific, but the potential it will have for driving better patient engagement is by no means so.

We will continue to share insights over time, but are always open for further conversations with anyone working towards better care management for patients with cancer.