Simulated Costs of the ASCO Patient-Centered Oncology Payment Model in Medicare Beneficiaries With Newly Diagnosed Advanced Ovarian Cancer
| Autor: | Laura H. Hendrix, Haley A. Moss, Frances F Wang, Mihaela V Georgieva, Michaela A. Dinan, Laura J. Havrilesky |
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| Rok vydání: | 2019 |
| Předmět: |
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Cost-Benefit Analysis MEDLINE Newly diagnosed Medical Oncology Medicare 03 medical and health sciences 0302 clinical medicine Cost Savings Patient-Centered Care medicine Humans 030212 general & internal medicine health care economics and organizations media_common Aged Neoplasm Staging Aged 80 and over Ovarian Neoplasms Advanced ovarian cancer Oncology (nursing) business.industry Health Policy Medicare beneficiary Cancer Fee-for-Service Plans Payment medicine.disease United States Hospitalization Incentive Oncology 030220 oncology & carcinogenesis Female Medical emergency Health Expenditures business Patient centered |
| Zdroj: | Journal of oncology practice. 15(12) |
| ISSN: | 1935-469X |
| Popis: | PURPOSE: Efforts to curb the rising costs of cancer care while improving quality include alternative payment models (APMs), which offer incentives to reduce avoidable spending and provide high-quality and cost-efficient care. The impact of proposed APMs has not been quantified in real-world practice. In this study, we evaluated ASCO’s Patient-Centered Oncology Payment (PCOP) model in existing fee-for-service (FFS) Medicare beneficiaries to understand the magnitude of potential cost savings. MATERIALS AND METHODS: SEER-Medicare data were used to identify women with advanced ovarian cancer diagnosed between 2000 and 2012 who either (1) underwent primary debulking surgery followed by chemotherapy or (2) received neoadjuvant chemotherapy followed by surgery. Medicare payments in each cohort were used to compare FFS and PCOP and to estimate the potential for cost savings across health care services received, including outpatient emergency department visits, hospitalizations, and imaging. RESULTS: Three thousand seven hundred seventy-seven primary debulking surgery and 866 neoadjuvant chemotherapy patients were included in the study, with mean total costs of $75,433 and $95,138 in 2016 US$, respectively Most costs were related to chemotherapy or hospitalization. Additional PCOP-related payments would be offset if hospitalizations could be reduced by 11.6% or imaging claims by 88%. CONCLUSION: APMs have the potential to reduce costs of current FFS reimbursement via either a large reduction in imaging or a modest reduction in hospitalizations during treatment of ovarian cancer. PCOP is a reasonable payment structure for oncologists if the additional payments can provide the necessary resources to invest in improved coordination of care. |
| Databáze: | OpenAIRE |
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