ASCO Alternative Payment Model Yields Savings in Ovarian Cancer

The American Society of Clinical Oncology’s (ASCO) Patient-Centered Oncology Payment (PCOP) model helps achieve costs savings in ovarian cancer when hospitalizations are reduced during the active treatment period, according to a study presented at the Society of Gynecologic Oncology’s (SGO) 2018 Annual Meeting.

While physicians continue to be interested in alternative payment models, they are often hesitant to adopt them due to risks and concerns of interoperability. ASCO proposed the PCOP model in 2015 to help practices meet the requirements of an alternative payment model. The PCOP model consisted of multiple new payments for key tasks not covered previously by fee-for-service, including new patient treatment planning, care management during treatment, care management during active monitoring, and participation in clinical trials.

Haley A Moss, MD, MBA,  of the Duke University Medical Center and Cancer Institute, and colleagues conducted a study to test the efficacy of the PCOP model. The researchers utilized the Surveillance, Epidemiology, and End Results (SEER) data linked with Medicare claims to identify 4643 women diagnosed with stage III-IV epithelial ovarian cancer between 2000 and 2012, all of whom received primary debulking surgery and either adjuvant or neoadjuvant chemotherapy. Researchers compared what the costs of care would have been under the PCOP model compared with costs associated with fee-for-service. 

Among the total patient population, the mean cost of chemotherapy and surveillance was $71,763 in the group of patients receiving adjuvant chemotherapy only compared with $90,058 in the group of patients receiving neoadjuvant chemotherapy.

In both groups of patients, the majority of fee-for-service costs were associated with chemotherapy or hospitalization, researchers observed. Hospitalizations were 62% and 60%, in the two groups of patients, respectively, and hospitalizations were expected to drop 8% overall under the PCOP model (54% vs 52% for the two groups of patients, respectively).

Importantly, researchers found that the PCOP model could achieve overall savings in advanced ovarian cancer if hospitalizations were reduced during the active treatment period. This finding, they explained, was apparent because reducing imaging or ED visits alone would not be enough to offset increased practice fees.

—Zachary Bessette