Representation of rural oncology practices in quality certification programs: Insights from QOPI and CoC data.

Abstract

e23291 Background: Quality certification programs like the ASCO Quality Oncology Practice Initiative (QOPI), focused on chemotherapy quality, and the American College of Surgeons Commission on Cancer (CoC) accreditation enhance cancer care standards. Rural areas, comprising ~19% of the US population, face barriers to quality oncology services due to limited resources and access. This study assesses rural practice representation in these programs to highlight opportunities for improving cancer care delivery in rural America. Methods: Data from QOPI-certified practices (n=217) and CoC-accredited programs (n=1093, after deduplication) were analyzed. Practices were categorized by Rural-Urban Commuting Area (RUCA) codes: Urban (1-3 or unclassified urban tracts), Micropolitan (4-6), Small Town (7-9), and Rural (10). Counts and percentages were calculated for each category in both datasets. Results: Rural practices were underrepresented in both programs. In QOPI, 185 (85.3%) were urban, 27 (12.4%) micropolitan, 1 (0.5%) small town, and 4 (1.8%) rural. In CoC, 947 (86.6%) were urban, 128 (11.7%) micropolitan, 8 (0.7%) small town, and 10 (0.9%) rural. Conclusions: The underrepresentation of rural oncology practices in QOPI and CoC certifications could potentially exacerbate quality disparities in cancer care. Opportunities include targeted ASCO outreach, resource support (e.g., tele-oncology, training grants), and streamlined certification processes to encourage rural participation, ultimately enhancing equitable care delivery in rural America. RUCA classification of quality-certified oncology practices. RUCA Category Description QOPI Practices n (%) CoC-Accredited Programs n (%) Urban Metropolitan core & high/low commuting (1-3) 185 (85.3) 947 (86.6) Micropolitan Micropolitan core & high/low commuting (4-6) 27 (12.4) 128 (11.7) Small Town Small town core & high/low commuting (7-9) 1 (0.5) 8 (0.7) Rural Primary flow to rural tracts (10) 4 (1.8) 10 (0.9) Total 217 (100) 1,093 (100)