KJZZ

As cancer treatment becomes ever more advanced, dedicated cancer centers in the Phoenix area have been growing. With that has come a barrage of billboard campaigns and TV commercials. In the second of two parts, KJZZ’s Nick Blumberg looks at how those centers can thrive and the criticism they face. 

Jamie Villa was treated for breast cancer at Banner MD Anderson in Gilbert, Ariz. (Photo by Nick Blumberg)

It’s estimated that more than 200,000 women were diagnosed with breast cancer last year. Jamie Villa was one of them -- young and healthy, she’d just run her first full marathon.

At Tuesday’s groundbreaking for an expansion of the nonprofit Banner MD Anderson Center in Gilbert, where she was treated, Villa stressed how important early detection is. And she said it was important to trust her intuition even when she heard things like: “‘Oh, you’re only 33, there’s no way there’s any problem with you.’ ‘I had a scare once too.’ ‘You just ran a marathon!’"

"You know, I heard lots of things," Villa said. "It’s better to feel like a little bit of a fool for ten minutes than to have a life-threatening disease that you don’t know about for months.”

After a year of treatment, Villa is almost completely recovered. She lives in the Valley, but many people come from out of town to have their cancer treated here. Maurie Markman is an oncologist and an executive with the Cancer Treatment Centers of America.

“The term that has been used by many, and I think it’s a fair term, is we’re a ‘destination hospital,’ and that patients come here, often from fairly long distances,” Markman said.

Markman’s organization is a for-profit national network of hospitals, with locations in the Phoenix area, Tulsa, Okla., Chicago, Atlanta, and Philadelphia. “You actually bring in patients who will get great care, but also spend dollars in the community, who might even someday decide to move,” Markman said.

So, if you don’t live in a market with one of these big oncology centers, how do you find out about them? One common way is advertising. Many of these hospitals engage in big ad campaigns -- TV and radio, in print and online, even on billboards along the highway. That doesn’t sit well with Bob Kuttner, co-editor of the left-leaning monthly The American Prospect.

“The fact that different hospitals are in an arms race with each other to attract patients adds nothing to the net medical well-being of the population,” Kuttner said.

Kuttner would rather see hospitals spend all their money on healthcare, instead of carving out a marketing budget. There’s also the debate over whether cancer centers (and hospitals in general) should be run as a nonprofit or a for-profit.

Kuttner thinks while nonprofits once were focused more on the mission of the medical profession: "The problem is that as the whole industry -- and I use the term deliberately -- has become more commercialized, nonprofit health insurance companies, hospitals, medical practices find themselves competing with for-profits.”

He says even nonprofits have big ad budgets, and invest in medical departments -- like oncology -- that pay the highest return.

But not everyone takes such a dim view of hospital motives. “Hospitals are businesses, and most of them are not-for-profit, but just because you’re not-for-profit, you still have to balance the books," said University of Arizona health economist Gautam Gowrisankaran. "Nobody’s going to subsidize the hospital if it’s losing money. You’re building facilities that are very, very expensive, that have high fixed costs, and you’ve got to bring in revenue to do that.”

And as major oncology centers expand, especially into new markets, Gowrisankaran thinks one way they can keep those fixed costs down is to form partnerships with other hospitals -- or even to work toward a national network of cancer care.

“There’s no reason for a hospital chain just to be local instead of national," Gowrisankaran said. "And in fact, from an economic point of view, it’s a much higher cost, because basically every little local chain has to figure out, what are the best practices and what [is] the best evidence-based medicine.”

Partnering with a local company isn’t a guarantee of success, though. One of the other important considerations is what market the cancer center is expanding into. Cancer Treatment Centers of America’s Maurie Markman says Arizona has been very hospitable to health care.

“The number of biotech companies, startup pharmaceutical-type of ventures, informatics companies related to healthcare that have been and will continue to come to Arizona is because of the very pro-business, pro-growth, pro-innovation climate," Markman said.

Arizona’s climate has certainly been good for the Cancer Treatment of Centers of America. Since opening here in 2008, the company says it’s grown by about 30 percent each year -- in staff and patients.

Read the first part of this series here.