title: Innovative Oncology Care Models Improve End-Of-Life Quality, Reduce Utilization And Spending.
abstract: Three models that received Health Care Innovation Awards from the Centers for Medicare and Medicaid Services (CMS) aimed to reduce the cost and use of health care services and improve the quality of care for Medicare beneficiaries with cancer. Each emphasized a different principle: the oncology medical home, patient navigation, or palliative care. Comparing participants in each model who died during the study period to matched comparators, we found that the oncology medical home and patient navigation models were associated with decreased costs in the last ninety days of life ($3,346 and $5,824 per person, respectively) and fewer hospitalizations in the last thirty days of life (fifty-seven and forty per 1,000 people, respectively). The patient navigation model was also associated with fewer emergency department visits in the last thirty days of life and increased hospice enrollment in the last two weeks of life. These promising results can inform new initiatives for cancer patients, such as the CMS Oncology Care Model.
authors.affiliation: Erin Murphy Colligan is a social science research analyst at the Center for Medicare and Medicaid Innovation, in Baltimore, Maryland.
authors.forename: Erin Murphy
authors.initials: EM
authors.lastname: Colligan
authors.affiliation: Erin Ewald is a research scientist at NORC at the University of Chicago in Bethesda, Maryland.
authors.forename: Erin
authors.initials: E
authors.lastname: Ewald
authors.affiliation: Sarah Ruiz is a senior scientist at the National Institute on Disability, Independent Living, and Rehabilitation Research, in Washington, D.C. This work was completed while she was a senior research scientist at NORC at the University of Chicago.
authors.forename: Sarah
authors.initials: S
authors.lastname: Ruiz
authors.affiliation: Michelle Spafford (spafford-michelle@norc.org) is a research scientist at NORC at the University of Chicago.
authors.forename: Michelle
authors.initials: M
authors.lastname: Spafford
authors.affiliation: Caitlin Cross-Barnet is a social science research analyst at the Center for Medicare and Medicaid Innovation.
authors.forename: Caitlin
authors.initials: C
authors.lastname: Cross-Barnet
authors.affiliation: Shriram Parashuram is a principal health economist at NORC at the University of Chicago.
authors.forename: Shriram
authors.initials: S
authors.lastname: Parashuram
mesh_terms: D000368:Aged; D017046:Cost Savings / Q000191:economics*; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data; D005260:Female; D017051:Hospice Care / Q000706:statistics & numerical data*; D006760:Hospitalization / Q000191:economics; D006801:Humans; D008297:Male; D008495:Medical Oncology / Q000458:organization & administration*; D006278:Medicare / Q000191:economics; D010166:Palliative Care / Q000706:statistics & numerical data; D062526:Patient Navigation; D018802:Patient-Centered Care / Q000458:organization & administration*; D011788:Quality of Life; D012189:Retrospective Studies; D014481:United States
keywords: Access To Care; Cancer Care; Elderly; End-of-Life Care