Policy analysis of access to and reimbursement for nonpharmacologic therapies for cancer-related fatigue.

Cancer-related fatigue (CRF) is an important public health issue that involves millions of community-dwelling cancer survivors. CRF is the most debilitating patient reported symptom related to cancer therapies and exacts a significant economic and social toll. It adversely impacts patients' work, social relationships, and overall quality of life. CRF prevalence ranges from 30% to 90% during therapy and often persists months and years afterwards. This policy analysis examines the problem of lack of patient access to evidence-based nonpharmacologic CRF therapies. The authors use a five-step process described by Teitelbaum & Wilenski (2017) to address the problem statement, identify key stakeholders, explore problem landscape, describe two viable policy options, and make a recommendation. The two policy options considered were: (a) insurer reimbursements modeled after existing cardiac rehabilitation programs and (b) health care provider incentives that incorporate the oncology care model (OCM) quality measure. Advantages and disadvantages of both options are presented. Public health nurses are uniquely positioned in their communities to advocate for these changes to improve population health.