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Employers Consider Centers of Excellence for Mohs Micrographic Surgery for Skin Cancer

The percentage of large employers using a Centers of Excellence (COE) strategy to contain healthcare costs has risen dramatically in recent years.

CARY, NC, UNITED STATES, March 17, 2022 / -- Skin cancer is the most commonly diagnosed cancer in the United States. Skin cancer greatly affects the quality of life, and it can be disfiguring or even deadly. Medical treatment for skin cancer creates substantial health care costs for individuals, families, and employers.

The number of Americans who have had skin cancer at some point in the last three decades is estimated to be higher than the number for all other cancers combined, and skin cancer incidence rates have continued to increase in recent years.

Each year in the United States, nearly 5 million people are treated for all skin cancers combined, with an annual cost estimated at $8.1 billion.

Skin cancer also results in significant costs beyond those related to treatment. Annual costs associated with lost workdays and restricted-activity days are estimated at $76.8 million for Non-Melanoma Skin Cancer and $29.4 million for melanoma.

The trends industry watchers have identified also found a significant increase in the percentage of employers looking into COEs within a health plan. The idea is for companies to encourage their workers to seek care at high-quality providers.

Quality and cost variation are pervasive and plague the U.S. health care delivery system. Centers of Excellence (COEs) are one strategy for steering employees to health care providers who practice efficiently, at a high quality, for reasonable and predictable prices.

COEs have traditionally covered procedures that are high cost for individual patients and are complex. For these conditions, like skin cancer surgery with Mohs micrographic surgery, patients are more willing to travel for the high- quality outcomes. Time-limited procedures are more easily reimbursed via bundled payments, which are incorporated into many COE contracts to ensure appropriate coordination of care back in the community and increase the predictability of costs.

Mohs micrographic surgery continues to be the most advanced and effective treatment procedure available for skin cancer. The goal of the procedure is to remove the skin cancer completely while minimizing the removal of uninvolved healthy tissue. It is performed under local anesthesia on an out-patient basis.

Advantages of Mohs surgery are highest cure rate (97-99%), entire margin evaluated, fewer recurrences, leaves the smallest surgical defect possible, preserves the maximal amount of tissue, increases the chance of a good aesthetic result, the most cost-effective treatment of select tumors and is done in the Outpatient setting, with local anesthesia, pathology included.

Mohs surgery is performed by a specially trained dermatologist (who serves as surgeon, pathologist, and reconstructive surgeon) and who has completed a one-to-two-year certified surgical fellowship. In October 2018, the American Board of Medical Specialties approved the application by the American Board of Dermatology to create the Micrographic Dermatologic Surgery (MDS) subspecialty. The first nationwide administration of the exam was held in October 2021. Now employers can look for Board Certification in MDS as well.

Recognizing the need for a Center of Excellence in Mohs Micrographic Surgery nationally, Surgical Review Corporation, SRC, a nonprofit, patient safety organization that accredits the top surgical facilities and medical professionals awarded accreditation to Cary Skin Center as a Center of Excellence in Mohs Micrographic Surgery. It is the first in the United States to achieve this recognition.

Established in 2003, SRC is a nonprofit, patient safety organization that develops and administers best-in-class accreditation programs for medical professionals, surgeons, hospitals, and freestanding outpatient facilities throughout the world.

These programs improve the safety and quality of patient care and lower the overall costs associated with successful treatment. Data, provided by program participants, is used to determine which treatments achieve the best outcomes. This information enables clinicians, patients, payors, and policymakers to make informed decisions that improve health care delivery.

P. Eales
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