Policy and Reimbursement Considerations for Exercise Programming in Cancer

Abstract

Health-care policy, profoundly impacts whether a cancer survivor can access exercise programming. Coverage determinations are the most potent policy lever as they dictate the extent to which exercise programming services are covered and whether health-care providers are incentivized to offer them. However, other types of policy also influence the range and quality of exercise programming available to cancer survivors. Specifically, policies influence the availability of screening for exercise needs; provider training and competency assessments; mandated on-site clinical exercise facilities, services, and specialists; and provision of patient education at critical points in their care trajectories. This chapter provides an overview of the diverse reimbursement and nonreimbursement policies in the commercial, government, and organizational sectors that influence exercise programming for cancer survivors. The chapter emphasizes the need for multi-pronged policy initiatives with the potential to collectively raise awareness, educate providers, enhance quality, and ensure access. Policy lessons learned from experiences in Germany and with cardiac rehabilitation are outlined.