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. 

For its advocacy approach to the 117th U.S. Congress that convened in January, ONS increased its emphasis on palliative care and patient access, developing its 2021 health policy agenda to reflect the evolving healthcare legislation landscape. 

From Teddy Roosevelt to JFK, presidents throughout history have sent legislation to Capitol Hill with the intent to expand healthcare coverage to more Americans. Finally, when Lyndon B. Johnson drafted a bill and pushed it through Congress by expanding sections of the Social Security Act, Medicare become an entitlement and is now implemented by the Centers for Medicare and Medicaid Services (CMS). During the past 50 years, federal health coverage has grown to include Medicaid, maternal and childcare assistance, public health programs, and prescription medication pricing.

To improve clinical trial availability, effectiveness, and diversity in the era of the COVID-19 coronavirus, National Cancer Institute (NCI)-funded clinical trials should adjust their design to increase use of telemedicine and remote informed consent, among other strategies, several NCI department leaders wrote in a commentary in the Journal of the National Cancer Institute.

When a patient comes to the doctor’s office with a generalized symptom such as an ongoing cough or chest heaviness, they are bound to have anxiety. In Wayne’s case, a patient with a lung mass that was identified unexpectedly, his anxiety was further compounded by feeling alone: his wife has dementia and his grown children live out of state. He also lives in a rural area and must drive a significant distance to get to a center for testing and diagnosis.

Many older adults are continuing cancer screenings beyond the recommended upper age limits, which range from age 65–75 years depending on the type of cancer screening, researchers reported in JAMA Network Open.

Telehealth resources have been present in the United States for several decades. Traditionally, clinicians used telehealth to help rural populations with limited access to care. However, telehealth innovations expand beyond home care coordination. We can use technology to reach even the most remote and vulnerable patients.  

Technology is synonymous with modern-day health care, and the experiences of 2020 have shown that telehealth allows clinicians to provide care along every inch of the cancer continuum. Although we’ve seen it used most recently to provide continuity of care from the safety of patients’ homes, one of telehealth's bigger purposes is overcoming geographic and practical disparities to enable more patients to access quality cancer care.

Rural Americans are more likely to have a fatal cancer diagnosis and face additional concerns like fewer hospitals and physicians in a “one-size-fits-all” healthcare system. To address the disparities, the Federal Communications Commission (FCC) partnered with the U.S. Department of Agriculture (USDA) to form the Rural Telehealth Initiative.

From 2015 to 2030, the costs associated with cancer will rise to $245 billion, researchers said in a report that was published in Cancer Epidemiology, Biomarkers, and Prevention.

No longer just a convenience, drive-throughs are an essential part of social distancing during the COVID-19 coronavirus pandemic. Retailers and healthcare providers alike have taken it beyond the typical food, prescriptions, and banking, offering everything from merchandise to virus testing—and now, thanks to the innovation of two oncology nurses, cancer care.

Many factors can affect the way patients access their care. But one thing is certain: if patients don’t get the care they need, their chances for success decline. To address barriers to cancer care, the American College of Surgeons’ Commission on Cancer (CoC) outlined specific, measurable actions that institutions must take.

Cancer does not stop progressing because of a pandemic. Although the COVID-19 coronavirus does not recognize that someone with leukemia has been fighting for months, even years, for remission to receive a lifesaving blood and marrow transplantation (BMT), a new program is ensuring that marrow products are available when patients need them. 

Precision medicine has a been a hot topic in health care for years now, but costs and coverage issues have created challenges to get patients the genetic testing they need at an affordable cost. In a memo from October 29, 2019, the Centers for Medicare and Medicaid Services (CMS) proposed extending Medicare coverage to pay for genetic sequencing tests for certain hereditary types of ovarian and breast cancer.

Reaching a broad audience, Department of Health and Human Services (HHS) Secretary Alex Azar spoke to the American Cancer Society’s Cancer Action Network in early September 2019 about the state of healthcare delivery in the United States and outlined the Trump administration’s priorities. Azar praised advocates for being leaders in promoting more investments for education, prevention, and research, and he noted the laudable achievements thus far.

With more deaths reported from vaping and a forceful U.S. Senate declaration to the U.S. Food and Drug Administration (FDA) acting commissioner to either enact stronger federal provisions restricting e-cigarettes, flavored tobacco, and inhalants or resign, the Trump administration moved quickly to demonstrate a recognition that cessation is a national, bipartisan concern. FDA sent a warning letter to Juul about its marketing and labeling, and the president, Health and Human Services secretary, and FDA commissioner issued very public statements on the matter, making it clear that federal oversight will be enforced on youth tobacco issues.

Cancer knows no race, color, nationality, or ethnicity. But although any person may one day develop cancer, incidence and mortality rates for some cancers are disproportionately higher in certain racial, ethnic, geographic, or socioeconomic groups. Here are just a few of the many identified cancer disparities, according to the National Cancer Institute.

In a letter to the U.S. Food and Drug Administration (FDA), Senator Dick Durbin (D-IL) shared harsh criticism for the agency’s lack of attention to the youth smoking epidemic. His letter from May 29, 2019, detailed efforts that the agency could be taking to curb the rise in youth tobacco use. The smoking cessation community, of which ONS is a palpable member, has sided with Durbin on the importance of continued FDA oversight on e-cigarettes and the vaping industry’s kid-friendly, fun-flavored tobacco products. Groups like the Campaign for Tobacco Free Kids have been forceful in comments to the agency about the need for stricter regulations on products.

Medicare Part D will continue to give patients access to certain cancer drugs, according Centers for Medicare and Medicaid Services’ (CMS’s) final ruling issued May 16, 2019. The final rule does not allow for utilization controls like step therapy and prior authorizations for patients who are already in an established treatment regimen; does not restrict drugs that have had certain price increases over a specified time period; and does not restrict new formulations of an existing protected class drug.

Patients with cancer are living longer, embarking on complex treatment regimens, and experiencing more complications associated with care. As a result, a large volume of patients with cancer require urgent or emergency visits throughout their disease trajectory. Although the need remains constant, what has evolved over time are the chief complaints that bring patients in, the care associated with complications, and new options to lower the burden and cost of care.    

Efforts to curb the national opioid epidemic have taken shape in several ways, including redefined prescription guidelines. However, many insurers are now refusing to cover certain pain medications like the ones commonly prescribed to patients with cancer. For years, ONS has been meeting with congressional offices to advocate that access to prescription opioids for cancer survivors should be exempt from the strict limits assigned to other diagnoses. It’s always been a successful strategy, because ONS helps policy leaders understand that patients with cancer often struggle with issues related to severe pain management, quality of life, and end-of-life care.

On January 3, 2019, the newly elected, Democrat-controlled House of Representatives introduced legislation to reopen the federal government and end the current shutdown. It’s not about the money, which is usually the case; it’s about the blame. The border wall funding—in whatever capacity—is politically driving the shutdown. But Senator Mitch McConnell (R-KY) doesn’t want to take up a Democrat-sponsored bill that he knows the president will veto. Democrats want that to happen to force the president to either accept the blame for the shutdown or to cave without funding for the wall and reopen the government.

Although the Democrats have yet not formally taken control of the House of Representatives, many are primed and passionate about holding the Trump administration accountable after the November midterm elections. Through involvement in committees and as incoming chairs of powerful oversight panels, lawmakers are questioning officials about healthcare policy.

With more than 70% of Americans supporting expanded Medicare, the single-payer Medicare for All rallying cry has gained significant support among progressives and moderates alike. A recent editorial report makes the case for its adoption with strong evidence from an economic point of view. During the November 2018 midterm election campaign, many incumbent Republicans—some of whom previously voted to repeal and replace the Affordable Care Act—now promised to uphold sections of the law, including protections for pre-existing conditions as their most important campaign commitment.

To Rally Voters, Democrats Focus on Health Care as Their Closing Argument

Although many states are already collecting early votes, Tuesday, November 6, 2018, will tell the full tale of the midterm elections. Many Democrats are emphasizing their focus on health care in the final days and hours before the election. By most measurable public opinion poll, health care remains the most important domestic issue for voters.

Fighting the cost of soaring prescription medications is a winning issue with tremendous bipartisan support. And reigning in exorbitant drug prices means patients will be the real winners. Recently, President Trump lauded his administration’s work to fight against high prescription drug costs, citing new efforts to reduce other countries from taking advantage of drug pricing.

Addressing the high cost of prescription medications has been an ongoing focus for the Trump administration. Its latest move, requiring drug companies to list their product’s market price on consumer ads, is an added level of transparency that didn’t exist before. Whether the decree will have an impact remains to be seen, but it may add some trust to the process.