Oncology Roundtable 2019 Cancer Patient Experience Survey Executive

Oncology Roundtable 2019 Cancer Patient Experience Survey Executive Briefing

3 The cancer patient experience survey Use Max. Diff analysis to prioritize patient preferences 2019 Cancer patient experience survey • 18 demographic questions What do cancer patients want…. 1 In a Provider? When deciding where to go for cancer care, which factor is the most important to you and which factor is the least important to you? • Five decision-related questions • Two max-diff questions 2 In Services? Thinking about your most recent experience, which service provided by a cancer center would have been the most valuable to you and which service would have been the least valuable to you? 2019 Cancer Patient Experience Survey Results Portal © 2019 The Advisory Board Company • advisory. com Source: 2019 Cancer Patient Experience Survey; Oncology Roundtable interviews and analysis.

4 The value of Max. Diff analysis Common market research tool used to prioritize product features Creating the perfect family car Which of the following would be the most and least important to you when choosing a car? Most Which of the following would be the most and least important to you when choosing a car? Least Most Which of the following would be the most and least important to you when choosing a car? Most Least Backseat cupholders DVD player Built-in carseats Third row seating Side airbags Backseat cupholders DVD player Third row seating Side airbags Least Attribute Ranking © 2019 The Advisory Board Company • advisory. com #1 Built-in carseats #2 Side airbags #3 DVD player #4 Backseat cupholders #5 Third row seating Source: Oncology Roundtable interviews and analysis.

5 How to interpret the data Results provide apples-to-apples comparison Importance of family car features Advantages of Max. Diff surveys Utility scores for the set of attributes sum to 100 33, 0 27, 0 24, 0 1 Allow researchers to understand the magnitude of difference between ranked attributes 2 Force respondents to choose between attributes, preventing ceiling effects Utility scores represent the relative value of each attribute, e. g. , backseat cupholders are preferred 3: 1 over third row seating 12, 0 4, 0 Built-in Carseats Side Airbags © 2019 The Advisory Board Company • advisory. com DVD Player Backseat Cupholders Third Row Seating Source: Oncology Roundtable interviews and analysis.

6 Understanding patient drivers of choice Force trade-offs to yield actionable information Max-Diff 1 When deciding where to go for cancer care, which factor is the most important to you and which factor is the least important to you? • Technology and treatment options • Clinical quality (e. g. , survival rates, number of treatments performed) • Location (distance from my home or work) • In-network for my insurance • Patient support services (e. g. , education, navigation) • Customer service (e. g. , interactions with staff, responsiveness to my questions) • Availability of appointments • Recommendation from my • Accreditation (e. g. , doctor accredited by the American College of Surgeons’ Commission on Cancer) • Doctor who specializes in my particular cancer • Reputation (e. g. , US News, “top doctors” report) • Costs I’m responsible for • Availability of clinical trials • Facility and amenities • Recommendation from a family member or friend (e. g. , access to wifi, onsite pharmacy) Format: 5 features per screen, 10 screens Oncology Roundtable related resource 2019 Cancer Patient Experience Survey Results Portal © 2019 The Advisory Board Company • advisory. com Source: 2085 Cancer Patient Experience Survey; Oncology Roundtable interviews and analysis.

7 Max. Diff 2 Teasing out distinctions between services Asking patients to differentiate among cancer center offerings Max-Diff 2 Thinking about your most recent experience, which service provided by a cancer center would have been the most valuable to you and which service would have been the least valuable to you? • Complementary and alternative medicine services (e. g. , acupuncture, yoga, massage) • Religious and spiritual services (e. g. , chaplain, prayer services) • Convenient and • Specialized symptom management services (e. g. , managing my pain, fatigue, nausea) • Extended hours of operation (e. g. , open late or on weekends) • A phone line to talk to a • Social and mental health nurse about my symptoms services for me during • An online portal where I can family members (e. g. , treatment (e. g. , patient • One person to answer view my test results and counselors, family support groups, counselors) my questions and help contact my care team support groups) me understand • Multidisciplinary care or • Access to genetic testing and • Financial counseling my care meetings where my entire genetic counseling (e. g. , help understanding care team discusses my case • Help scheduling and • All of my care taking place in insurance, costs, coordinating my • Free or discounted one building (e. g. , imaging, financial aid) appointments, visits, transportation appointments, treatment) • Patient education transportation • Survivor support services for • Help with nutrition services and classes me after I finished treatment (e. g. , orientation, what to expect during treatment) • Support services for my affordable parking Format: 5 features per screen, 15 screens © 2019 The Advisory Board Company • advisory. com Source: 2019 Cancer Patient Experience Survey; Oncology Roundtable interviews and analysis.

9 Age distributed, majority of respondents white Age at diagnosis Race Years 35 -54 White 34% 18 -34 10% 84% 24% 55 -64 33% 65+ © 2019 The Advisory Board Company • advisory. com 2% Other 8% 2% 4% Asian Hispanic or Latino Black or African American Source: 2019 Cancer Patient Experience Survey; Oncology Roundtable interviews and analysis.

10 Distribution across gender, tumor type Tumor type Gender Unsure 1% Other Lung 8% Female 15% 62% 8% Male Stomach Breast 14% Skin 38% 20% 1% 10% Blood or Lymphatic Colon or Rectum 7% 11% 5% Prostate Cervix, Ovary, Brain, Head, or Uterus or Neck © 2019 The Advisory Board Company • advisory. com Source: 2019 Cancer Patient Experience Survey; Oncology Roundtable interviews and analysis.

11 Education and income evenly distributed Education Income Less than High School 2% Graduate or Professional Degree $150 K $200 K 4% 13% High School Bachelor’s Degree Prefer Not to Say 2% 3% >$200 K $150 K <$25 K 19% 11% 37% 26% 13% 22% 25% $75 K $100 K 21% Associate’s Degree © 2019 The Advisory Board Company • advisory. com $25 K $50 K - $75 K Source: 2019 Cancer Patient Experience Survey; Oncology Roundtable interviews and analysis.

12 Majority received surgery, completed treatment Type of treatment received 1 Status of treatment 4% Chemotherapy or Other Drug Therapy 67% Radiation Therapy 66% 4% Newly Diagnosed 1 24% Active Treatment 2 72% Surgery None 6% Completed Treatment 39% Elected Not to Receive Treatment Type of provider 6% Unsure Physician Office 43% 33% 1) Respondents were asked to select all that apply, answers do not sum to 100. 2) Diagnosed within the two months prior to completing the survey. 3) Diagnosed more than two months prior to completing the survey, still undergoing treatment. © 2019 The Advisory Board Company • advisory. com Community Hospital Academic Medical Center 32% Source: 2019 Cancer Patient Experience Survey; Oncology Roundtable interviews and analysis.

13 Insurance status, enrollment on HDHP Insurance status At time of diagnosis 1 Employer-Sponsored 39% Purchased Directly from Insurer or Federal or State Health Exchange 10% 29% Medicare Medicaid Military (TRICARE, VA) Indian Health Services No Insurance Unsure 15% 4% 0% 2% 1% 1) Respondents were asked to select all that apply, answers do not sum to 100. © 2019 The Advisory Board Company • advisory. com Source: 2019 Cancer Patient Experience Survey; Oncology Roundtable interviews and analysis.

14 Distribution across nation, community setting Region Setting West Midwest 19% Rural 24% 47% 32% 36% Suburban 22% 24% South © 2019 The Advisory Board Company • advisory. com Northeast Urban Source: 2019 Cancer Patient Experience Survey; Oncology Roundtable interviews and analysis.

15 Comorbidities prevalent amongst cancer patients Did a physician diagnose you with any of these other conditions before your diagnosis of cancer or while you were receiving treatment? n=1, 201 Diabetes 65% of patients diagnosed with one or more conditions either before diagnosis or during treatment 14% Not diagnosed with another condition Cardiovascular disease 6% 35% 10% COPD 16% Other 1 2% Chronic renal failure 1) Other comorbidities included: Hypertension, hyperthyroidism, fibromyalgia, Crohn’s disease, HIV, hepatitis C and lupus © 2019 The Advisory Board Company • advisory. com Source: 2019 Cancer Patient Experience Survey; Oncology Roundtable interviews and analysis.

17 Max Diff 1 What cancer patients want in a provider When deciding where to go for care, which feature is most and least important? Mean utility scores n=1, 201 17, 5 Doctor who specializes in my particular cancer 13, 3 Technology and treatment options 12, 3 Recommendation from my doctor 11, 1 Clinical quality 10, 8 In-network for my insurance 6, 5 Costs I’m responsible for 5, 5 Accreditation Reputation 4, 9 Customer service 4, 8 3, 4 Location Availability of appointments 3, 1 Patient support services 2, 9 Availability of clinical trials Recommendation from my family and friends Facility and amenities © 2019 Advisory Board • All rights reserved • advisory. com 1, 6 1, 4 0, 8 Source: 2019 Cancer Patient Experience Survey; Oncology Roundtable interviews and analysis.

18 Max Diff 2 Patient priorities for services and amenities Which services would have been most valuable and least valuable to you? Mean utility scores n=1, 201 Specialized symptom management 11, 0 All of my care takes place in one building 10, 9 9, 2 Multidisciplinary care clinics 9, 0 One point of contact to help me understand my care 7, 1 Online portal to view test results, contact care team 6, 7 Patient education services 5, 9 Nurse phone line for help with symptoms 5, 4 Survivor support services after finishing treatment 4, 6 Social and mental health services during treatment 4, 5 Financial counseling 4, 4 Help scheduling and coordinating my appointments 3, 5 Access to genetic testing and counseling 3, 5 Complementary and alternative medicine 3, 3 Support services for my family 3, 0 Extended hours of operation Help with nutrition 2, 3 Religious and spiritual services 2, 3 2, 1 Parking that is convenient and affordable Free or discounted transportation © 2019 Advisory Board • All rights reserved • advisory. com 1, 5 Source: 2019 Cancer Patient Experience Survey; Oncology Roundtable interviews and analysis.

19 Where patients go for more information Which of the following resources did you use when deciding where to go for your cancer care? n=1, 201 My doctor 81% Cancer center, physician practice website 34% My health insurance company 33% Family friends or colleagues 23% Cancer-specific website 19% Major search engine 15% Medical-focused ratings website Medicare or other government website 12% 7% Social media website 5% I did not consult any resources 4% General ratings website 4% Employee health navigation site 3% Community website forum or blog 3% Other 3% © 2019 Advisory Board • All rights reserved • advisory. com

20 The internet a top source of information Which of the following resources did you use when deciding where to go for your cancer care? n=1, 201 My doctor 81% Cancer center, physician practice website 34% My health insurance company 33% Family, friends, or colleagues 23% Cancer-specific website 19% Major search engine 15% Medical-focused ratings website Medicare or other government website 12% 7% Social media website 5% I did not consult any resources 4% General ratings website 4% Employee health navigation site 3% Community website, forum, or blog 3% Other 3% © 2019 Advisory Board • All rights reserved • advisory. com 48% of cancer patients searched online when deciding where to go for care 2. 1 average number of sites consulted by patients searching online

21 Support services valued by cancer patients Of the support services listed below, please select the 3 that you believe would be most valuable during your experience with cancer n=1, 201 32% Relaxation therapies Information on medical marijuana Creative expression therapies Accupuncture Sexual health counseling Beauty salon/services 45% 9% 25% 8% 39% 7% 7% 6% Ranked first © 2019 Advisory Board • All rights reserved • advisory. com 44% 13% Access to fitness classes Chemo cold caps 75% 18% 27% 20% 25% Ranked in top 3 Source: 2019 Cancer Patient Experience Survey; Oncology Roundtable interviews and analysis.

22 Survivorship services valued by cancer patients Many cancer centers offer survivorship care programs for patients who have completed active treatment. Which elements of a survivorship care program would you find most valuable? n=1, 201 22% Guidance on signs of recurrence Care plan with treatment and side effects 49% 15% Guidance on managing physical side effects 47% 10% Guidance on managing emotional side effects Guidance on diet, exercise, and healthy living 9% Help coordinating post-treatment visits 9% 33% 30% 29% 7% Guidance on financial and insurance issues 23% 5% In-person support groups with other survivors Guidance on advocating for my own health. . . 3% Online/virtual support groups 3% Ranked first © 2019 Advisory Board • All rights reserved • advisory. com 50% 18% 15% 14% 10% Ranked in top 3 Source: 2019 Cancer Patient Experience Survey; Oncology Roundtable interviews and analysis.

23 Patient interest in group survivorship visits Almost half of patients express interest in attending What is your level of interest in attending group visits as part of your survivorship care? n=1, 201 Very interested 47% interested Somewhat interested Not too interested Not at all interested Source: 2019 Cancer Patient Experience Survey; Oncology Roundtable interviews and analysis. © 2019 Advisory Board • All rights reserved • advisory. com

24 Why cancer patients switch providers Why did you change cancer care providers? n=127 11% of cancer patients switched providers I found a different doctor who specializes in my care 28% 23% I wanted more/different treatment options I wanted better customer service 20% 18% I found a higher quality program I wanted a location that was closer to my home/work 17% Friends of family recommended a different provider 13% They could not provide the treatment I needed 13% I wanted better support services 10% I wanted access to clinical trials I wanted a nicer facility and better amenities I couldnt get appointments when I needed them I wanted to spend less money on my care Other © 2019 Advisory Board • All rights reserved • advisory. com 7% 6% 4% 3% 31% Source: 2019 Cancer Patient Experience Survey; Oncology Roundtable interviews and analysis.

25 Why cancer patients switch providers Across your experience with cancer, why, if ever, did you miss an appointment? n=127 11% of patients missed appointment throughout treatment I couldn't afford the costs 12% My insurance didn't cover it 11% I took too long to get to my appointment 9% I did not feel well 35% It conflicted with my work schedule 15% I didn't have transportation to get to my appointment I was unable to secure child care 18% 4% I was at the emergency room or was admitted to. . . 16% I forgott/had the wrong appointment time 20% Extreme weather conditions Other © 2019 Advisory Board • All rights reserved • advisory. com 19% 9% Source: 2019 Cancer Patient Experience Survey; Oncology Roundtable interviews and analysis.

26 How cancer patients chose where to get treatment How did you decide where to go for your treatment? n=1, 201 Surgery Chemotherapy Radiation I got a recommendation from my doctor and I followed it 90% 85% 91% I got a recommendation from my doctor but I chose to go somewhere else 5% 5% 4% I did not receive a recommendation from my doctor, and chose a place to go for treatment on my own 5% 6% 3% I have not yet decided where I will go for this treatment <1% 4% 1% Source: 2019 Cancer Patient Experience Survey; Oncology Roundtable interviews and analysis. © 2019 Advisory Board • All rights reserved • advisory. com

27 Patients want to participate in their care decisions What is your preferred level of control when making decisions about your cancer treatment? n=1, 201 50% 38% 3% 7% 2% I make the My doctor and I My doctor decisions with decisions after make the makes the little or no input seriously decisions decsisions after decisions with from my doctor considering my together seriously little or no input doctor's opinion considering my from me opinion Source: 2019 Cancer Patient Experience Survey; Oncology Roundtable interviews and analysis. © 2019 Advisory Board • All rights reserved • advisory. com