Sick. Americans are literally sick of the financial burden vulnerable patients endure because of high out-of-pocket, healthcare-related costs. The complicated and convoluted issue has no easy solution.

ONS member Ryne Wilson, DNP, RN, OCN®, care coordinator at University of Minnesota Physicians, joined an expert panel to discuss policy solutions for advancing equitable cancer care for the LGBTQ+ community during the National Comprehensive Cancer Network Patient Advocacy Summit in December 2022. The panel focused on issues affecting LGBTQ+ people with cancer, including homophobia, transphobia, systemic racism, and social determinants of health.

Four academic institutions will create centers of excellence dedicated to telehealth in cancer care to help healthcare providers increase its use in oncology practice, thanks to $23 million in National Cancer Institute (NCI) funding. The awards are part of NCI’s Telehealth Research Centers of Excellence initiative, which is supported by President Joe Biden’s Cancer Moonshot initiative.

Veterans exposed to toxic substances in service will have more access to cancer care and other medical assistance thanks to the recently signed Sergeant First Class Heath Robinson Honoring our Promise to Address Comprehensive Toxics Act. The PACT Act passed with bipartisan effort by Congress in August 2022 and later signed into law.

Pending legislation would help residents save on prescription drug costs by empowering Medicare to negotiate lower drug prices, capping out-of-pocket costs, and limiting pharmaceutical price increases to the rate of inflation, U.S. Senator Jack Reed (D-RI) said during a discussion with a plethora of healthcare professionals, including ONS member Heather Murphy, MSN, FNP, OCN®, president of the ONS Rhode Island and Southeastern Massachusetts Chapter, about rising prescription drug prices at a Rhode Island conference in July 2022.

To support the objectives of President Joe Biden’s relaunched Cancer Moonshot initiative, the Centers for Disease Control and Prevention awarded $215 million to three national cancer programs in June 2022. The funds are part of a $1.1 billion investment in cancer prevention and control.

To decrease cost and increase access to care, in July 2022 the Centers for Medicare and Medicaid Services proposed a conversion factor of $33.08 for the 2023 Physician Fee Schedule.

Financial considerations are notable barriers for patients with cancer receiving follow-up cancer care, according to study findings from the National Institutes of Health (NIH) All of Us Research Program.

Research and practice changes funded through healthcare legislation have influenced today’s care delivery across all settings: hospitals, clinics, and even homes. And with their constituents laser-focused on health in today’s pandemic society, legislators have never made that happen so quickly.

Launched in 2016 as a pilot program from the Centers for Medicare and Medicaid Services Innovation Center to develop new payment and delivery system models, the Oncology Care Model had a lofty goal: drive improvements in providing high-quality and cost-effective care.

A pandemic is not the time to experiment with Medicaid work requirements, the Biden-Harris administration maintained in April 2022 when it urged officials in Arkansas and New Hampshire to cancel their U.S. Supreme Court hearing appeals regarding the Trump administration orders and send the matter back to the U.S. Department of Health and Human Services (HHS) for further action.

An April 2022 Biden-Harris administration executive order on Continuing to Strengthen Americans’ Access to Affordable, Quality Health Coverage will protect and strengthen the Affordable Care Act (ACA) and Medicaid. The order directed federal agencies and departments to review existing language and correct regulatory wording that might be inconsistent with the goals of offering more affordable access to health care.

Nearly a quarter of patients who are eligible for cervical cancer screening are overdue for their current tests, researchers said in study findings published in JAMA Network Open. The number grew nearly 10% since 2005—representing a steady increase in missed screening over time—and was higher in different sociodemographic groups because of factors related to social determinants of health.

Virtual appointments and other telehealth care allow patients and families to have ready access to cancer care from the comfort of their own home, Kevin M. Curtis, MD, medical director of the Center for Telehealth at Dartmouth-Hitchcock Health, said in a March 2022 National Cancer Institute (NCI) blog post praising the service. Curtis also highlighted telehealth’s role in addressing health disparities, its high satisfaction rate with both patients and clinicians, and the service’s future in cancer care research.

Cancer is one of the top five most expensive healthcare conditions to treat, costing the United States more than $157 billion annually. The payout from patients’ pockets may be even greater, with the cost of cancer medications alone standing at $895 billion per year. But paying for cancer during a pandemic? Even financially secure patients with healthcare coverage are struggling.

Healthcare organizations and agencies across the country, including the U.S. Department of Health and Human Services (HHS), prioritized enhancing and expanding services like maternal and postpartum care and sexual and reproductive health during Women’s History Month, HHS announced in March 2022.

Home care is a patient-centered ambulatory care option that improves treatment adherence, symptom management, length of hospital stays, cost of care, psychosocial well-being, and quality of life. It is the future of care delivery, creating a “more accessible, effective, efficient, safe, and economical sustainable system.”

Out-of-pocket prescription drug costs for beneficiaries with Medicare Part D could start to lower with improved price transparency and market competition thanks to a January 2022 proposed rule from the Centers for Medicare and Medicaid Services (CMS). The rule, which would take effect on January 1, 2023, would improve beneficiaries’ experiences with Medicare Advantage and Medicare Part D and work to improve health equity in the programs, according to CMS.

Consumers will more easily find affordable healthcare coverage in 2023, thanks to the Biden-Harris administration’s December 2021 Notice of Benefit and Payment Parameters 2023 Proposed Rule, according to the U.S. Department of Health and Human Services’ (HHS) Centers for Medicare and Medicaid Services (CMS). The rule also improves shopping for healthcare coverage, establishes rules to ensure people have access to care, and advances health equity for consumers purchasing Marketplace coverage.

Advancing equity, justice, and opportunity for Asian American (AA) and Native Hawaiian and Pacific Islander (NHPI) communities in the United States requires an ambitious, whole-of-government agenda, the U.S. Department of Health and Human Services (HHS) announced in December 2021. To drive that agenda, the agency launched the Biden-Harris administration’s White House Initiative on Asian Americans, Native Hawaiians, and Pacific Islanders (WHIAANHPI).

As cancer care delivery changes, oncology nurses step up to the challenge: they adapt and develop solutions to fuel the future of nursing education, certification, and practice. During the November 2021 ONS Hackathon™, launched in partnership with the Oncology Nursing Certification Corporation (ONCC), teams were tasked to identify methods that address issues in the delivery of cancer care and prepare the future nursing workforce to care for patients with cancer anywhere.

Unprecedented new funding will expand and diversify the country’s healthcare workforce, address workforce shortages, and support more than 22,700 healthcare providers committed to working in underserved communities, according to a statement from the White House. Vice President Kamala Harris announced the $1.5 billion investment into the National Health Service Corps, Nurse Corps, and Substance Use Disorder Treatment and Recovery programs in November 2021.

A pioneer and internationally recognized expert in translational genomics and precision medicine will guide the scientific vision, strategy, and data collection for the next phase of the National Institutes of Health’s (NIH’s) All of Us Research Program, the agency announced. In November 2021, NIH appointed Geoffrey Ginsburg, MD, PhD, to serve as the program’s chief medical and scientific officer.

The urban-rural disparity in hepatocellular cancer (HCC) diagnoses is widening, researchers said, particularly in certain racial, income, and age groups. The authors reported their study results in Clinical Gastroenterology and Hepatology.

The COVID-19 coronavirus pandemic has forced healthcare providers to make unprecedented adjustments to patient care, including the pivot to telehealth. At a series of virtual events from October 2020–March 2021, ONS members shared their challenges, successes, and future needs to permanently adopt virtual cancer care visits.

Racial inequality persists across the entire healthcare spectrum—from patient disparities to the healthcare workforce’s current makeup and even to the education of the next generation of practitioners. But nurse scientists conducting clinical trials have the opportunity to change that.

Under a newly refreshed strategy, the Centers for Medicare and Medicaid Services’ (CMS) Innovation Center is expanding models in the healthcare industry that reduce program costs and improving quality and outcomes for Medicare and Medicaid beneficiaries, the agency announced in an October 2021 white paper.

Few political and policy issues resonate with all Americans as much as the costs of prescription medications, particularly those for acute and chronic diseases that affect the body and spirit, like cancer. Seizing the opportunity for real change, in August 2021 President Joe Biden made a major announcement about his administration’s intent to change the dynamic on the financial impact of drugs and government oversight.

Despite its now-widespread use, telehealth still poses barriers for many patients, such as limited access in rural areas and privacy concerns. In August 2021, the Biden-Harris administration announced the investment of billions of dollars to meet immediate COVID-19 needs and help improve hospital care to rural communities. The funding includes more than $19 million in telehealth to improve the initiative in rural and underserved communities.

After a decade and three legal challenges that culminated in another U.S. Supreme Court decision to uphold the law, the Patient Protection and Affordable Care Act ([ACA], commonly known as Obamacare) is currently established canon. On June 17, 2021, the Supreme Court of the United States (SCOTUS) ruled in favor of the defendants in the case of California et al. v. Texas et al., maintaining ACA’s constitutionality. It was a firm 7-2 decision.

When ONS reached out and asked me to participate in the inaugural ONS Hackathon, I wasted no time in confirming my interest. I had heard of hackathons before but never a nursing-specific one. It was an exciting experience full of growth for me and the other oncology nurses who participated.

Innovative, affordable, and accountable care are the key to transforming the healthcare system to achieve health equity, according to the Centers for Medicare and Medicaid Services (CMS) Innovation Center’s 10-year plan, which the center announced on August 12, 2021.

U.S. Department of Health and Human Services (HHS) Secretary Xavier Becerra celebrated the Children’s Health Insurance Program’s (CHIP’s) 24th anniversary on August 4, 2021, a program that “for more than two decades, has been a lifeline for millions of children and families across America,” with an incredible announcement: in 2020 and 2021, CHIP provided more than 6.8 million enrolled individuals with coverage during the COVID-19 coronavirus pandemic.

As individual diseases, cancer diagnoses like pheochromocytoma (cancer of the adrenal gland), neuroendocrine cancers, and malignant mixed Mullerian tumors (also called carcinosarcomas) are rare, but collectively they’re more common than breast, colon, lung, or prostate cancer.

The United States is worst among 11 high-income countries in delivery of and access to health care, according to an August 2021 study conducted by the Commonwealth Fund, despite spending the most, by far, of its gross domestic product (GDP) on health care than other countries surveyed. The survey used indicators across domains on access to care, care process, administrative efficiency, equity, and healthcare outcomes to compare healthcare system performance. Overall, the top-performing countries were Norway, the Netherlands, and Australia.

When President Biden signed the American Rescue Plan Act of 2021 into law in March 2021, the administration began working to make improvements in areas such as access and affordability by increasing eligibility for financial assistance. The new law lowered premiums for most people who currently had a Marketplace health plan and expanded access to financial assistance for more consumers, and data published in July 2021 showed that from February 15–June 30, 2021, more than 1.5 million Americans signed up for new health insurance coverage using the 2021 Marketplace Special Enrollment Period (SEP).

To achieve value-based, person-centered care, the U.S. healthcare system must promote sustainability and readiness to prepare for future public health emergencies such as the COVID-19 coronavirus pandemic, the Centers for Medicare and Medicaid Service (CMS) said. In August 2021, CMS announced that the Hospital Inpatient Prospective Payment System and Long Term Care Hospital Prospective Payment System final rule will take effect on October 1, 2021, in support of that work.

The COVID-19 coronavirus pandemic has shed light on the U.S. healthcare system’s wide range of issues, from accessibility to barriers and social determinants of health. The country must respond with strategies to address future public health emergencies, the U.S. Senate Health, Education, Labor and Pensions (HELP) Committee said in an April 2021 letter.

Nursing has long been associated with healing hands. Laying hands on patients’ bodies is personal and intimate, providing comfort, soothing reassurance, strength, and hope. It builds a sacred trust that engenders care. When that foundational element of nursing was removed to follow social distancing protocols during the COVID-19 coronavirus pandemic, nurses found a new avenue to connect with their patients—through the use of telehealth.

Efficiently running an ambulatory infusion clinic is a complex process that requires evolving strategies to equip staff to provide high-quality cancer care. During the June 2021 ONS Hackathon^TM, oncology nurse innovators created solutions to address ineffective nursing resources in infusion centers across the United States.

Historical and structural racism is a huge barrier to quality health care that has created two tiers of access to care and a lack of understanding of the healthcare system. Government health agencies and leaders, such as the U.S. Agency for Healthcare Research and Quality (AHRQ), are tackling racial disparities in health care directly to change the dynamic to equality for all Americans. AHRQ says it is assessing its own agency and examining how professionals can make the health services research field more diverse and inclusive by building on a foundation that includes producing and promoting the annual National Healthcare Quality and Disparities Report and AHRQ’s social determinants of health database. By recognizing disparities related to race and ethnicity, income, and other social determinants, the organization plans to further address historical racism in health care.

Approximately 31 million Americans now have healthcare coverage through the Affordable Care Act (ACA), according to a June 2021 issue brief from the office of the assistant secretary for planning and evaluation (ASPE). Of those, 11.3 million consumers were enrolled in Marketplace plans, 14.8 million people were newly enrolled in Medicaid, 1 million individuals were enrolled in ACA’s Basic Health Program option, and nearly 4 million previously eligible adults gained coverage under the Medicaid expansion due to enhanced outreach and increased federal funding. Additionally, insurance rates have fallen across the country since the law’s implementation 11 years ago.

On March 22, 2021, Xavier Becerra, BA, JD, became the first Latino appointed as secretary of the U.S. Department of Health and Human Services (HHS), and announced the agency’s focus on ensuring affordable and accessible health care for every American. 

The American Cancer Society, along with 14 other healthcare groups advocating for increased access to care, filed an amicus curiae—Latin for “friend of the court”—urging the U.S. Supreme Court to deny state imposition of engagement requirements, like monthly community service, for Medicaid beneficiaries. The U.S. Supreme Court is likely to spend spring deliberating and convey a judgment before the end of summer.

The rate of uninsured young adults (aged 19–25) fell by more than one third between 2009 and the first quarter of 2014 following the Affordable Care Act’s (ACA’s) Medicaid expansion, according to a February 2021 report from the Urban Institute. With the expansion, young adults also reported improved overall health, increased access to care, and fewer high out-of-pocket costs. 

Thrust into the mainstream in 2020, telehealth has transformed how patients with cancer receive some of their care, substituting certain traditional in-person office or clinic visits for phones, videos, and apps and devices that monitor patients’ health. It’s improved access to care in areas previously considered at risk for disparities: for example, patients in remote locations can be managed in an acute-care setting using television monitors, cameras, and call buttons to contact specialists. 

Although society has tried to take steps to confront gender disparities, women remain underrepresented across various sectors. Title IX in 1972 granted every American student the right to education without gender discrimination. However, female students still bear the brunt of sex-segregated programs and gender-based violence, two major obstacles to educational equality. Women consistently earn less than their male counterparts. The wage gap is larger for most women of color, and gender discrimination and sexual harassment in the workplace perpetuate economic divides. More women work today than ever before, but they face barriers to leadership roles, such as stereotypes about their performance abilities, uneven demands of motherhood compared to male partners, and the reality that many workplaces prefer and reward masculine leadership styles. Health needs are substantially greater for older women compared to older men, but women reported fewer visits with a physician and lesser likelihood to stay in a hospital. 

To increase access to breast and cervical cancer screening, U.S. Congress passed the Breast and Cervical Cancer Mortality Prevention Act of 1990, which led to the creation of the National Breast and Cervical Cancer Early Detection Program (NBCCEDP). Because of NBCCEDP, eligible women who are low-income, underserved, and underinsured receive free breast and cervical cancer screening and diagnostic testing. 

Climate change was a core issue throughout the Biden-Harris campaign trail, and many advocacy groups are clamoring for the new administration to keep its promises. Recognizing the link between environmental concerns and health care, U.S. Representative Lauren Underwood (D-IL) introduced a bill that addresses both topics.