Cancer Treatment Centers of America (“CTCA”) is a network of cancer hospitals providing state of the art cancer treatment in the United States. CTCA operates as a for profit specialty hospital and health care network with facilities in all regions of the contiguous United States. With patient cancer survival rates above national benchmarks, the Mother Standard of Care has proven to be an effective model for patient treatment and for business success.
CTCA has introduced both process innovations and clinical innovations to the treatment of cancer diagnoses. A core competency that has distinguished CTCA from other providers is the Patient-Empowered Care “PEC” approach. The PEC approach is grounded in the original vision upon which the CTCA organization was created, which is the patient comes first. This approach of multi-member care team providers revolving around the patient, as opposed to the patient being required to move from one clinician to the next for treatment has resulted in increased productivity, better communication among the member of the care team, and most importantly, increased patient satisfaction.
Another example of process innovation is the Commissioning Team, tasked with the responsibility of opening new CTCA sites as the organization expands. Responsibilities above and beyond the physical structure include selection of appropriate staff to fit into and complement the culture that CTCA has cultivated across its network. Another core competency is the electronic health record system that is standardized across the CTCA network. The EHR has enhanced collaboration and communication across the network, and coupled with a bar coding system, has improved patient care by decreasing medication errors. Maintenance of a brand standard and cultivation of innovation resulted in the creation of an Innovation Analyst position at each facility within the CTCA network. This core competency results in CTCA being able to study innovation at each of its facilities and leverage it across the network.
CTCA also introduced chemotherapy advancements including intra-arterial chemotherapy and metronomic chemotherapy. Yet another core competency is the approach of clinical research with a focus on research to improve patient outcomes as opposed to discovery for the sake of collecting new knowledge.
As CTCA has grown as an organization and increased its national presence, the organization is faced with the challenge of continuing growth while maintaining the culture of care it has established. Additionally, the organization is facing a swing in the population of the patients it serves, with patients in the earlier stages of cancer seeking treatment making up a larger portion of its patient panel as opposed to patients with advanced stage and complex cancers. The organization is faced with reconciling the benefit of moving its care model towards treatment strategies for early stage cancers.
Options for future growth for CTCA include continued national expansion by establishing a hospital in the central portion and of the United States, specifically the Montana, North Dakota, South Dakota and Wyoming area. This would result in comprehensive representation in all the United States regions. In addition to building a facility in the northwestern region, CTCA should consider adding outpatient/ ambulatory type facilities to facilitate care of the early stage cancer diagnosis population. Patients in the early stage of cancer do not require the same intensity of services required by patients with advanced stages of cancer. CTCA could establish centers that are accessible and have lower associated costs. The accessibility component would include establishing the outpatient centers in those states where there is not a CTCA hospital, which would enable early stage cancer patients to obtain affordable care in a timely and cost efficient manner. Patients with advanced stage and complex cancers could travel to one of the established CTCA hospitals for treatment.
CTCA should also investigate participation in value-based care and pay for performance collaboration with major national health insurers. The goals of value-based care are care structured around patients and their needs, with measured outcomes and costs, bundled payments for episodes of care within integrated care delivery systems, expanded geographic reach, and an established and effective EHR to facilitate coordination of care. With CTCA’s proven track record of quality outcomes within an environment that focuses on patient centric care delivery in a cost efficient manner, and established and proven effective EHR, and a national presence, the organization is well positioned for success in such arrangements.
Table 1. CTCA Progress Towards Goals of Value Based Care

References:
Herzlinger, Regina E., and Natalie Kindred. "Cancer Treatment Centers of America® (A)." Harvard Business School Case 313-012, August 2012. (Revised March 2014.)
“History of Cancer Treatment Centers of America.” CancerTreatmentCenter.com. http://www.cancercenter.com/about-us/history/

George B. Moseley, Managing Health Care Business Strategy, (Jones and Bartlett Publishers, 2009).

Porter, Michael E., and Thomas Lee. “The Strategy That Will Fix Health Care.” Harvard Business Reivew, October 2013. http://hbr.org/2013/10/the-strategy-that-will-fix-health-care/