See the published version of this preprint at Supportive Care in Cancer.
This is a preprint, a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
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Research Article
Barbara Daly
Case Western Reserve University
Corresponding Author
ORCiD: https://orcid.org/0000-0003-1977-5941
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Purpose: This article reports findings from a demonstration project funded by the Center for Medicare and Medicaid Innovation (CMMI). The purpose of the project was to test a supportive care program to achieve the “triple aim” of improving quality of care of patients, enhance patient experience, and reduce costs in patients with advanced cancer.
Methods: The project was conducted between February 2015 and February 2018, enrolling adult, Medicare or Medicaid beneficiaries with advanced or progressed solid tumor malignancy. A comparative longitudinal comparison of the program with both a concurrent control and an historic control was used to evaluate outcomes. The intervention included routine electronic biopsychosocial screening, early access to specialty palliative care, and nurse care coordination. Quality of life, aggressiveness of care, and health care utilization were measured.
Results: 1340 people were enrolled, with 71% of the total sample being Caucasian; 41.4% had Stage IV cancer, and 20% utilized Medicaid only. Significant differences in the enrolled patients and the comparison group were controlled for through statistical analysis. There were significantly fewer ED visits, unplanned admissions and fewer total hospitalization days. Almost all measures reflected a lower aggressiveness of care for enrolled patients. Of patients who died, a significantly greater portion of enrolled patients were enrolled in hospice prior to death. Quality of life had a marked improvement for enrolled patients. Average cost per member per month was not less in the enrolled group.
Conclusion: This pragmatic demonstration project provided valuable insights which can position organizations for successful integration of supportive care under value-based reimbursement.
Keywords
palliative care, care coordination, supportive care, cancer care
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CURRENT STATUS: Published
View the published article at Supportive Care in Cancer.
Version 1
Posted 11 Jun, 2021
No community comments so far
Reviews received
Received 12 Jun, 2021
Reviewers invited
Invitations sent on 07 Jun, 2021
Editor assigned
On 18 May, 2021
First submitted
On 10 May, 2021
Metrics
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PDF Downloads: ...
HTML Views: ...
Subject Areas
Oncology
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A new preprint design is coming!
We have improved readability, clarity, accessibility, and opportunities for engagement.
See the published version of this preprint at Supportive Care in Cancer.
This is a preprint, a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research Article
Barbara Daly
Case Western Reserve University
Corresponding Author
ORCiD: https://orcid.org/0000-0003-1977-5941
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Published
View the published article at Supportive Care in Cancer.
Version 1
Posted 11 Jun, 2021
No community comments so far
Reviews received
Received 12 Jun, 2021
Reviewers invited
Invitations sent on 07 Jun, 2021
Editor assigned
On 18 May, 2021
First submitted
On 10 May, 2021
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Oncology
License:
This work is licensed under a CC BY 4.0 License. Read Full License
View the published article at Supportive Care in Cancer.
Purpose: This article reports findings from a demonstration project funded by the Center for Medicare and Medicaid Innovation (CMMI). The purpose of the project was to test a supportive care program to achieve the “triple aim” of improving quality of care of patients, enhance patient experience, and reduce costs in patients with advanced cancer.
Methods: The project was conducted between February 2015 and February 2018, enrolling adult, Medicare or Medicaid beneficiaries with advanced or progressed solid tumor malignancy. A comparative longitudinal comparison of the program with both a concurrent control and an historic control was used to evaluate outcomes. The intervention included routine electronic biopsychosocial screening, early access to specialty palliative care, and nurse care coordination. Quality of life, aggressiveness of care, and health care utilization were measured.
Results: 1340 people were enrolled, with 71% of the total sample being Caucasian; 41.4% had Stage IV cancer, and 20% utilized Medicaid only. Significant differences in the enrolled patients and the comparison group were controlled for through statistical analysis. There were significantly fewer ED visits, unplanned admissions and fewer total hospitalization days. Almost all measures reflected a lower aggressiveness of care for enrolled patients. Of patients who died, a significantly greater portion of enrolled patients were enrolled in hospice prior to death. Quality of life had a marked improvement for enrolled patients. Average cost per member per month was not less in the enrolled group.
Conclusion: This pragmatic demonstration project provided valuable insights which can position organizations for successful integration of supportive care under value-based reimbursement.
Figure 1
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