There is a need for research that evaluates the impact of the many changes now occurring in the healthcare system with a particular focus on cancer prevention, control, and treatment. Efforts focusing on improving access to care may also impact inequities that contribute to health disparities. Public health policy initiatives such as the federal and state marketplaces that have expanded insurance coverage, as well as Medicaid expansion in some states, create natural experiments ripe for evaluation. Research to be funded by this RFA should focus on the changes in national, state, and/or local policy and the response to these changes by healthcare systems, insurers, payers, communities, practices, and patients.
A clear understanding of these changes can help clinicians, health systems, public health and public policy professionals, patient and consumer advocates, and providers to identify and guide needed improvements in cancer prevention and control and health care and health more broadly. Findings from this research may also inform advocacy and policy development by the American Cancer Society Cancer Action Network (ACS CAN) in the context of meaningful health care reform by assessing outcomes related to the structure of the health system on availability, administrative simplicity, adequacy, and affordability of coverage, referred to as the 4 A’s, which make up the Society and Cancer Action Network's framework for reform.