Healthcare News of Note: Many new cancers in the U.S. may be going undiagnosed, a study by Quest Diagnostics shows

• A study shows new cases of eight types of cancers may be going undiagnosed, leading study authors to call for healthcare providers to plan to address the consequences of delayed diagnoses, including strengthened telehealth offerings that support patient-clinician interaction.
• Virginia hospitals filed 59% fewer lawsuits against patients for unpaid medical bills in the year after a 2019 research article was released along with subsequent media coverage of the practice, according to a recent study.
• Positive interaction with healthcare leadership increases healthcare workers’ well-being and the safety culture of an organization, a study found.

Over the last few weeks, I have found these industry news stories that should be of interest to healthcare finance professionals.  

1. Quest Diagnostics: Many new cancers in the U.S. may be going undiagnosed

A Quest Diagnostics study published Aug. 31 in JAMA Network Open suggests many new cancers in the U.S. may be going undiagnosed, as the mean monthly patient numbers for eight types of cancer from November 2020 to March 2021 remained significantly lower when compared with the pre-pandemic period.

“Our findings call for planning to address the consequences of delayed diagnoses, including strengthened clinical telehealth offerings supporting patient-clinician interactions,” wrote the study authors.

The study included U.S. patients who received testing at Quest Diagnostics for any cause from January 2018 through March 2021, and whose ordering physicians assigned ICD-10-CM diagnosis codes associated with eight cancer types: breast (female patients only), colorectal, lung, pancreatic, cervical, gastric, esophageal and prostate.

Cancer trends over 27 months

The team evaluated monthly trends for four periods:

Pre-pandemic – January 2019 to February 2020

The mean monthly number of patients with newly identified cancer was highest for prostate cancer (13,214), followed by breast (9,583), colorectal (4,101), lung (3,015), pancreatic (1,177), cervical (493), gastric (415) and esophageal (409). 

March to May 2020

The mean monthly number of new diagnoses fell 29.8%, from 32,407 to 22,748, for the eight cancers combined. Declines were significant for all cancer types, ranging from 21.2% for pancreatic to 36.1% for breast.

June to October 2020

The mean monthly number of patients newly diagnosed with cancer was 29,304 — a 9.6% decrease relative to the pre-pandemic period — for the eight cancers combined. Diagnoses were statistically the same level as pre-pandemic for all cancers except prostate. 

November 2020 to March 2021

The mean monthly patient numbers — 26,204, a 19.1% decrease — remained significantly lower compared with the pre-pandemic period for all eight cancers. However, the magnitude of declines was lower than during the first period.

2. Virginia hospitals filed substantially fewer lawsuits against patients for unpaid medical bills after a study of such practices was made public, research shows

Virginia hospitals filed 59% fewer lawsuits against patients for unpaid medical bills in the year after a 2019 research article was released along with subsequent media coverage exposing the practice, according to results of a cross-sectional study published Aug. 23 by JAMA Network Open. Eleven hospitals banned the practice altogether.

Other results

During the preintervention period, hospitals sued for a total of $38,700,209, compared with $13,960,300 in the postintervention period. Analysis showed decreases of:

• 55% in the number of warrant-in-debt cases filed
• 66% in the number of wage garnishments filed
• 64% in the dollar amount pursued in court

“These findings suggest that research and public health initiatives rooted in media exposure can increase public accountability for hospital billing practices and result in meaningful changes that benefit patients,” the authors wrote.

3. Positive interaction with healthcare leaders increases workers’ sense of well-being and improves organizational safety culture

Positive interaction with leadership improves healthcare workers’ well-being and the safety culture of an organization, according to a results of study published in the July issue of The Joint Commission Journal on Quality and Patient Safety.

“Interventions to decrease burnout and increase well-being in health care workers (HCWs) and improve organizational safety culture are urgently needed,” the authors wrote. “This study was conducted [in a large academic healthcare system] to determine the association between Positive Leadership WalkRounds (PosWR), an organizational practice in which leaders conduct rounds and ask staff about what is going well, and HCW [healthcare worker] well-being and organizational safety culture.”

Leadership training and visits with staff

All system leaders from managers and directors on up were invited to participate in two-day off-site training sessions that were offered multiple times as part of a leadership development series, with more than 1,500 leaders participating.

Leader visits typically occurred monthly, lasted 30  to 60 minutes and involved three to 10 healthcare workers, a local leader and a senior leader. The types of questions the visiting leaders asked included the following:

• From your perspective, could you share three things that are going well in this work setting, and one thing that could be better?
• Is there anyone you would like to give a shout-out to today, and can you elaborate with specific examples?

Survey respondent details

Electronic surveys were returned from 396 work settings by 10,627 of 13,040 possible survey respondents, which is an overall response rate of 81.5%. The top three respondent groups were:

• Registered nurses (31.7%)
• Attending physicians (9.7%)
• Technologists (8.2%)

Respondents in settings with higher exposure to positive visits by leaders were more likely to give positive marks in areas such as patient safety, teamwork and work-life balance.

“To our knowledge, this is the first study to show that leadership efforts at pausing and reflecting on what is going well with HCWs (PosWR) is associated with better safety culture and workforce well-being,” the authors wrote.