Cancer carve outs, specialty networks, and disease management: a review of their evolution, effectiveness, and prognosis.
Specialty care programs for patients with cancer were among the first to be developed, yet they have been some of the slowest to grow or to demonstrate success. This paper reviews the evolution of cancer carve outs, disease management, and specialty networks by distinguishing purchasers from sellers on key attributes. It also describes financing and operational impediments to their growth and summarizes what little published data there is documenting the success of these programs. The paper analyzes the critical factors impeding the development of these cancer programs, and discusses the public policy changes and health services research that will need to be conducted before the performance and market influence of cancer carve outs will reach their full potential.