ADVERTISEMENT
How Does the Oncology Care Model Affect Different Types of Hospitals?
Study identifies hospital characteristics that may require special consideration as alternative payment models expand in oncology care (JCO Oncol Pract. 2021;17[8]:e1150-e1161. doi:10.1200/OP.21.00050).
“With the introduction of the Oncology Care Model and plans for the transition to Oncology Care First, alternative payment models (APMs) are an increasingly important piece of the oncology care landscape,” explained Joel Segel, PhD, Department of Health Policy and Administration, Penn State University, University Park, PA, and colleagues.
“Evidence is mixed on the Oncology Care Model's impact on utilization and costs, but as policymakers consider expansion of similar models, it is critical to understand the characteristics of hospitals that may be differentially affected,” they continued.
This study used SEER-Medicare data from 2007 to 2016 to identify patients with breast and prostate cancer who received chemotherapy, endocrine therapy, or androgen deprivation therapy.
Dr Segel and colleagues calculated 6-month expected mortality, emergency department (ED) visits, inpatient admissions, and costs for each hospital. Observed-to-expected rates for each outcome were calculated by hospital. To better understand the association hospital characteristics associated with each outcome, researchers estimated the association between observed-to-expected rates and characteristics of each hospital.
Study findings showed rural hospitals had significantly higher-than-expected mortality (.31 points higher, P <.001) and ED visit rates (.10 points higher, P = .029) as well as significantly lower costs (.06 points lower, P = .004). In addition, hospitals unaffiliated with a medical school had significantly higher-than-expected mortality and ED visits.
There were significantly higher ED visits reported for hospitals eligible for disproportionate share hospital payment, however they experienced lower costs. Higher-than-expected mortality was seen in for-profit hospitals.
“Rural hospitals and those unaffiliated with a medical school may require special consideration as APMs expand in oncology care. Designated cancer centers and larger hospitals may be advantaged,” concluded Dr Segel and colleagues.—Janelle Bradley
