Community Oncology Palliative Care Program as an OCM Quality Improvement Effort

A palliative care program launched at Michigan Health Professionals—a large community oncology practice participating in the Oncology Care Model (OCM)—provided more care at home and at a lower cost for participating patients.

This trend may be replicated in comparable community settings, according to the researchers.

Adil Akhtar, MD, oncology division of Michigan Health Professionals, and colleagues presented at the ASCO Annual Meeting on a palliative care program launched in October 2017. Palliative and end-of-life care was identified as one of the OCM quality improvement areas at the time.

A multidisciplinary palliative care team was led by board-certified palliative care and hospice physicians. Patients deemed appropriate for palliative care referral were identified by participating medical oncologists. Patients were then contacted by the palliative care team and if they agreed to participate, a nurse practitioner would assess and follow the patients at home. Care was coordinated by the nurse practitioners in communication with the palliative care team and the primary medical oncologists.

To determine whether the palliative care program was helping Michigan Health Professionals’ performance in OCM performance period 3, last 30-day OCM program claims data was analyzed by Integra Connect.

Over a 12-month span from the launch of the program, a total of 273 patients were referred to the palliative care program. Fifty-eight patients were identified as having OCM episodes, of these 36 patients had claims data through June 2018. Twenty patients accepted and engaged with palliative care, while 16 patients declined or were unable to reach for palliative care (comparison group).

After excluding drug and office costs, 30-
day claims data showed that palliative care patients spent 17% less than their comparison counterparts ($93,000 vs $112,000, respectively). Similarly, palliative care was associated with lower acute facility costs, which accounted for 50% ($46,000) of reimbursement compared with 95% ($105,000) for the comparison group.

Furthermore, 80% of palliative care patients met the quality measure for OCM performance period 3, compared with 0% for those who declined palliative care.

Michigan Health Professionals’ palliative
care program is reaching patients in OCM episodes, though the patient accrual numbers are still small and will continue to grow, Dr Akhtar said in an interview. Nonetheless, the
initial results are still promising and shed light on an important measure that community setting OCM participants can take to improve their care for patients.—Zachary Bessette