Closing the gap: A collaborative cancer care delivery model to ease travel burden for rural cancer patients.

189 Background: Emblematic of the rural cancer care gap, patients with cancer living in the southwest region of Montana incur an additional financial burden caused by a need to travel significant distances to receive their care, often resulting in suboptimal outcomes. For those living in Dillon, Montana, receiving cancer treatment required driving over 100 miles each way, complicated by extreme winter conditions for 4 to 6 months a year. To address this issue, Barrett Hospital and Healthcare (BHH), a critical access hospital, established a rural Cancer Infusion Center (CIC) to address this barrier to cancer care. Methods: A collaboration with Bozeman Health Deaconess Cancer Center (BHDCC) enabled the establishment of an oncology service line at BHH. BHDCC provides oncology expertise and resources, assisting in the coordination of care and providing guidance on treatment for patients seen at BHHC. Standardized treatment protocols were established to facilitate seamless communication and care delivery between the two sites, ensuring coordinated access to care at the local site. Daily operations of the CIC include a Physician Associate and an oncology certified nurse. An oncologist from Bozeman Health Cancer Center provides onsite oncology consultations two days per month. Additional support is provided by service lines within BHH such as outpatient infusion, hospitalist service, and outpatient clinic support staff. Results: Patients in Dillon were able to begin receiving onsite diagnostic consultations and treatment planning visits in March 2024. Additionally, infusion services became available in October 2024, with the opening of a 4-chair infusion suite. Patients have been able to receive both treatment and follow-up care totaling over 280 patient visits to date, saving an estimated 64,000 miles in travel and 13,650 in attributable fuel costs alone. Further, the travel burden was reduced by 1,120 hours of drive time, which could conservatively translate to over 30,000 in increased income (based on Montana average salary of $27.00/hour). Conclusions: The positive outcomes observed in Dillon, MT, including reduced travel burden and associated financial toxicity, and increased access to specialized cancer care, highlight the potential of collaboration between CAHs and regional cancer centers to address the rural cancer care gap. This pilot project provides a valuable blueprint for developing and implementing similar strategies in other remote communities, ensuring increased access to essential oncology services closer to where patients live.