The data reviewed included sociodemographic information, cancer history, treatment and results from screening tests like breast mammograms and ultrasounds. Financial data about procedure costs and reimbursement to the health system were then obtained to evaluate the projected and actual costs of procedures and reimbursement to the health system, based on insurance status.

The results show that the overall rate of adherence to recommended procedures was 50 percent. The average cost of recommended procedures for the adherent group was $1,211, whereas the projected cost for the non-adherent group was significantly higher at $2,469. Thus, the non-adherent group left more potential revenue (“lost opportunity cost”) for the health system.


It was estimated that per visit, the health system received an average of $850 in profit for patients in the adherent group. Conversely, the non-adherent group’s recommended care included higher cost procedures with a more considerable potential profit margin for the health system. It was estimated that the health system would have received an average of $1,932 in profit per visit if these patients had completed all recommended procedures.

The total lost profit to the health system due to non-adherence was $311,850.

Potential for reform

“The findings show that a modest investment of resources on the part of the health system to improve adherence amongst survivors can provide a positive return on investment,” said Dr. Fish, Section Head, Survivors Facing Forward program, Cohen Children’s Medical Center. “Small changes, like communication between survivor teams and health system administration, can have a big impact on improving care for survivors.”

Dialogue between care-support teams and administration around patient barriers may be able to increase patient-adherence, with a minimal investment of time and resources. This action could improve the health and quality of life for survivors and provide a return on investment for the health system.

“Recognizing that patient care is the utmost priority for all health systems, it’s imperative that we implement programs that patients can successfully adhere to in the long term,” said Charles Schleien, MD, senior vice president and chair of pediatrics at Northwell Health. “Doing so not only aids in keeping our patients cancer free, it also improves their overall quality of life for years to come.”


About the Feinstein Institutes
The Feinstein Institutes for Medical Research is the research arm of Northwell Health, the largest health care provider and private employer in New York. Home to 50 research labs, 2,500 clinical research studies and 4,000 researchers and staff, the Feinstein Institutes is raising the standard of medical innovation through its five institutes of behavioral science, bioelectronic medicine, cancer, health innovations and outcomes, and molecular medicine. We’re making breakthroughs in genetics, oncology, brain research, mental health, autoimmunity, and bioelectronic medicine – a new field of science that has the potential to revolutionize medicine.

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