Alternative Payment Model Cut Cancer Care Costs, Preserved Quality
An experimental payment method for physicians who treated patients with three types of cancer resulted in the same quality of care but lower costs, according to a study published Monday in the Journal of Oncology Practice, Modern Healthcare's "Vital Signs" reports.
For the study, which was conducted from October 2009 to December 2012, insurer UnitedHealth Group paid physicians at five medical oncology groups a single payment to cover all of breast, colon and lung cancer patients' expected treatment, rather than using the traditional fee-for-service payment system (Rice, "Vital Signs," Modern Healthcare, 7/8). The oncology groups also conducted semi-annual, in-person discussions on best practices and methods to better standardize care (Humer, Reuters, 7/8). Researchers compared the groups' patients' results with those of patients of providers who received fee-for-service payments (Newcomer et al., Journal of Oncology Practice, 7/8).
By the end of the study, costs for 810 patients treated for breast, lung and colon cancer by the five oncology groups were $65 million, compared with $98 million for similar patients whose physicians received fee-for-service payments (Reuters, 7/8). According to lead author Lee Newcomer, other similar pilot projects found cost reductions of about 5% ("Vital Signs," Modern Healthcare, 7/8).
Researchers said the lower costs resulted from a reduction in medical imaging and radiation treatments and fewer hospital stays, which often are caused by the side effects of chemotherapy (Reuters, 7/8).
During the study, the oncology groups performed well compared with the national average on more than 60 different measures of costs and quality, including admissions for symptoms related to treatment, death rates, drug costs per episode, radiology use and patient relapse time periods.
However, chemotherapy costs "paradoxical[ly] increased" for the episode payment group compared with the standard payment group ("Vital Signs," Modern Healthcare, 7/8). Researchers were unsure if this occurred because of an increase in drug prices or an increase in chemotherapy treatment (Reuters, 7/8).
National Comprehensive Cancer Network CEO Robert Carlson praised the study but said more research is needed to determine whether "merely the knowledge that participation in the study or that the costs of care were being monitored changed physician behavior and not the method of payment."
Newcomer said that all five oncology practices intend to continue participating in the program and that he intends to triple the program's size next year ("Vital Signs, Modern Healthcare, 7/8).This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.