How the National Cancer Institute is Reengineering Healthcare Delivery
Imagine two patients with the same cancer diagnosis receiving the exact same cutting-edge treatment, yet one experiences better outcomes and quality of life. Why? The answer often lies not in the treatment itself, but in how that treatment is delivered. While breakthrough therapies grab headlines, the complex system through which care reaches patients—including coordination, communication, and accessibility—can determine whether advanced medicine fulfills its promise.
Recognizing this challenge, the National Cancer Institute (NCI) has embarked on a transformative mission: to revolutionize not just what cancer treatments we have, but how they actually reach and benefit patients.
This silent revolution in healthcare delivery research is bridging the gap between scientific discovery and real-world impact, ensuring that advances in cancer care benefit everyone, everywhere.
Focusing on individual needs and experiences
Addressing healthcare system challenges
Using data to drive improvements
When we think of cancer research, we often picture scientists in labs studying cells or clinical trials testing new drugs. Healthcare delivery research represents a different, equally crucial frontier. It examines how cancer care is actually provided to patients and how this delivery affects their outcomes and well-being. This multidisciplinary science seeks to improve clinical results and patient experiences by addressing factors at the patient, clinician, and organizational levels that influence care delivery 5 .
Healthcare delivery research tackles real-world challenges including growing demands for cancer care, increasing treatment complexity, inadequate care coordination, dramatic cost increases, persistent disparities in care outcomes, and insufficient use of evidence-based guidelines 5 .
Consider these real-world challenges: growing demands for cancer care, increasing treatment complexity, inadequate care coordination, dramatic cost increases, persistent disparities in care outcomes, and insufficient use of evidence-based guidelines 5 . Healthcare delivery research tackles these very issues by asking critical questions: Why do proven cancer screenings reach some populations but not others? How can we better coordinate care among specialists? What systems help patients manage treatment side effects more effectively?
By finding answers to these practical questions, this field aims to ensure that every patient receives the right care at the right time in the right way—regardless of their background, location, or economic status.
Recognizing the critical importance of these delivery challenges, the NCI created the Healthcare Delivery Research Program (HDRP) in 2015 as a dedicated catalyst for expanding work in this field 1 5 . This program operates with a clear mission: "to advance innovative research to improve the delivery of cancer-related care, thereby improving health for individuals and populations" 1 . Its vision is equally straightforward—"optimal health outcomes for individuals, families, and communities affected by cancer" 1 .
HDRP Established
Community Practices
States in NCORP Network
Key Approaches
Supporting studies that examine how cancer care is delivered across diverse settings and populations 5
Creating and maintaining platforms that enable robust healthcare delivery research 5
Overseeing accessible data resources that allow researchers to evaluate patterns, costs, and patient experiences of care 5
Supporting training and professional development to grow the healthcare delivery research workforce 5
One of HDRP's flagship initiatives is the NCI Community Oncology Research Program (NCORP), which brings cancer clinical trials and care delivery studies to people in their own communities 3 . This network represents a crucial innovation because it allows researchers to study and improve care delivery in the very settings where most cancer patients actually receive treatment—local hospitals and oncology practices rather than academic medical centers.
To understand how healthcare delivery research works in practice, consider a compelling example of research in action. A recent NCI/HDRP-funded study (R37CA240807) led by Dr. Katie Devine of Rutgers Cancer Institute addressed a critical gap in cancer care: the unique challenges faced by young adults with cancer 2 .
A cancer diagnosis can derail lives at a particularly vulnerable time—just as young adults are launching careers, building relationships, starting families, or becoming financially independent. Compared to older adults, young adults with cancer often report higher emotional distress and poorer quality of life, yet traditional support systems frequently fail to address their specific needs 2 .
Dr. Devine and her team developed and tested a novel intervention called Bright IDEAS-Young Adults (Bright IDEAS-YA). This program teaches practical problem-solving skills through six one-on-one sessions, delivered via telehealth for accessibility 2 .
the problem
the options
those options
on the plan
if it worked
Presented at the 2025 ASCO Annual Meeting, the findings from this randomized trial demonstrated both statistical and clinical significance 2 . The Bright IDEAS-YA program significantly reduced depression and anxiety while improving overall quality of life for participants. The telehealth delivery method proved particularly promising for scalability, potentially reaching patients even in community cancer centers where specialized psycho-oncology services might be limited.
As Dr. Devine explained in the ASCO Post, "By giving them a set of skills that they can use, I believe we're empowering them to take on a lot of the challenges that come with a cancer diagnosis and treatment" 2 .
This study exemplifies how healthcare delivery research develops and tests practical strategies that directly improve patients' experiences and outcomes, complementing traditional biomedical research.
The tools available to healthcare delivery researchers have expanded dramatically in recent years, thanks in large part to NCI's investment in research infrastructure. These resources enable scientists to ask and answer complex questions about how cancer care is delivered across the nation.
| Resource Name | Description | Research Applications |
|---|---|---|
| SEER-CAHPS | Links cancer registry data with patient experience surveys and Medicare claims data 2 8 | Studying how patient-reported care quality varies by geographic and other factors |
| SEER-MHOS | Combines cancer registry data with health outcomes survey data from Medicare beneficiaries 2 8 | Examining cancer health outcomes, health-related quality of life, and activities of daily living |
| HINTS (Health Information National Trends Survey) | Collects data on how Americans find, use, and understand health information | Informing cancer communication strategies and public awareness campaigns |
These data systems enable research that would otherwise be impossible. For example, the SEER-MHOS resource allows investigators to examine crucial questions about cancer survivors' quality of life, functioning, and experiences with care by linking detailed clinical information from cancer registries with patient-reported outcomes 2 .
Similarly, the HINTS program tracks how Americans access and use cancer information, helping shape more effective public health communication campaigns . The HINTS Data Linkage Project combines survey responses with external data on social and economic factors, demographics, information technology access, and even built environment characteristics .
As healthcare delivery research evolves, several promising areas are emerging:
With dramatic increases in Medicare Advantage enrollment over the past decade, HDRP has launched new initiatives to examine cancer-related care quality and access within this growing program 2 .
Research on multidisciplinary, interprofessional team-based care delivery models aims to improve care coordination and quality across the cancer continuum 2 .
Initiatives like the Persistent Poverty Initiative work to alleviate the cumulative effects of long-term poverty on cancer outcomes by building research capacity and promoting community-based programs 7 .
While developing effective interventions is crucial, ensuring they reach all who could benefit remains a significant challenge. Scale-up research—the study of how to expand successfully tested innovations to benefit more people across diverse settings—has emerged as a critical priority 4 .
| Research Characteristic | Number of Grants | Percentage of Portfolio |
|---|---|---|
| Total Scale-Up Grants | 17 | 100% |
| Prevention Focus | 11 | 64.7% |
| Screening Focus | 7 | 41.2% |
| International Setting | 6 | 35.3% |
| Cost-Benefit Assessment | 9 | 52.9% |
Source: Analysis of NCI's research portfolio (2016-2023) 4
| Research Priority | Current Focus | Future Directions |
|---|---|---|
| Scale-Up Research | Identifying barriers and facilitators to expanding successful interventions 4 | Testing specific implementation strategies for scale-up |
| Care Coordination | Understanding teaming challenges in screening and risk assessment 2 | Developing and testing team-based care models across the cancer continuum |
| Health Equity | Documenting disparities in care delivery and outcomes 5 7 | Implementing and evaluating interventions to address disparities |
| Data Infrastructure | Linking clinical, survey, and cost data 2 8 | Developing real-time data systems to support learning healthcare systems |
The work of the National Cancer Institute in advancing healthcare delivery research represents a crucial evolution in our approach to cancer. While the development of new treatments remains essential, ensuring these innovations reach all patients effectively, efficiently, and equitably is equally important. Through the strategic efforts of the Healthcare Delivery Research Program, NCI is building the scientific evidence needed to transform cancer care from a patchwork of inconsistent practices into a reliable, high-quality experience for every patient.
This research has moved beyond academic theory to tangible impact—from helping young adults develop problem-solving skills to navigate their cancer journey, to improving care coordination in local communities, to addressing the systemic factors that perpetuate cancer disparities. As these efforts continue to expand and evolve, they bring us closer to a future where every person facing cancer receives care that is not only medically advanced but also compassionately delivered, well-coordinated, and accessible regardless of who they are or where they live.
The revolution in cancer care delivery may be less visible than dramatic new drug announcements, but its impact is equally profound—transforming the patient experience and ensuring that our scientific progress against cancer translates into longer, healthier lives for all.
References will be added here in the required format.