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Analyzing If An Oncology Care Model Will Improve Care and Lower Costs


Highlights

  • Cancer strikes 1.6 million Americans each year, imposing huge costs
  • We’re evaluating an oncology care model that seeks to improve care and lower costs by linking payment to quality of care, improving delivery of care, and improving health information sharing
  • Initial evaluation results are expected in late 2018
The Challenge

Cancer strikes 1.6 million Americans each year. It imposes huge costs: heartache, death, and an estimated $263.8 billion in medical care and lost productivity in 2010, the most recent data available. Cancer care is complex and improving it faces a legal barrier: health-information sharing can improve care, but data sharing could conflict with privacy rights.

The Approach

Under a contract with the Centers for Medicare & Medicaid Services (CMS), Abt Associates is leading a team that uses a mixed-methods approach to evaluate an oncology care model (OCM) to improve care and lower costs. The model focuses on three main areas: linking payment to quality of care; improving delivery of care; and improving health information sharing while protecting privacy. The evaluation explores the characteristics of the oncology physician group practices that voluntarily participate in the OCM. The project uses a carefully constructed comparison group to measure whether changes over the five-year test are greater in intervention practices than in comparison practices –a difference-in-differences evaluation design. The evaluation focuses on several issues. How care delivery changes under the OCM. Which OCM design elements contribute most to success. Which contextual factors affect program success. And most important, the impact of the OCM on quality of care, health outcomes, utilization, and cost.

The mixed method design uses data from many sources, including Medicare administrative data systems, other CMS contractors implementing the OCM, applications completed by oncology physician group practices and other payers, case studies, and surveys completed by patients, clinicians, and oncology physician group practices practice leaders. We are conducting a mixed methods analysis of unintended consequences of OCM and factors influencing the potential scalability of the model. Rapid-cycle reporting provides CMS with quarterly updates on oncology physician group practices activities and summative outcomes.

The Results

An interim report on the first six months is expected in late 2018. The second annual report with more results is expected in late 2019.