Researchers developed a methodology that can help identify high-value oncology care, using cost of care per patient per day in breast cancer episodes of initial, survivorship, and relapse care (JCO Oncol Pract. 2021;OP2000462. doi:10.1200/OP.20.00462).
“To estimate the value of cancer care and to compare value among episodes of care, a transparent, reproducible, and standardized cost computation methodology is needed,” wrote Douglas W Blayney, MD, Stanford Cancer Institute, Stanford University School of Medicine, CA, and colleagues.
“Charges, claims, and reimbursements are related to cost but are nontransparent and proprietary,” they continued.
This lead Dr Blayley and colleagues to develop a method to measure the cost of different episodes of care among patients with breast cancer: initial treatment with curative intent, surveillance and survivorship care, and relapse and end-of-life care.
Clinical data from the Stanford electronic health record, California state cancer registry, and the Social Security Death Index were combined and used. The breast cancer care was analyzed and Common Procedural Terminology codes were mapped to the corresponding cost conversion factor and date in the CMS Medicare fee schedule. Cost of care per day was calculated for each patient to account for varying duration of episodes of care.
The median cost of care per day for initial treatment was $29.45, for surveillance and survivorship care was $2.45, and for relapse care was $13.80. There was no difference in cost of care per day between HER2-negative, HER2-positive, and triple-negative breast cancer.
Significantly shorter survival was reported among patients with relapsed disease in the most expensive surveillance cost of care per day group.
“We developed a method to identify high-value oncology care—cost of care per patient per day—in episodes of initial, survivorship, and relapse care. The methodology can help identify positive deviants (who have developed best practices) delivering high-value care,” concluded Dr Blayley and colleagues.
“Merging our data with claims data from third-party payers can increase the accuracy and validity of the CCPD,” they added.—Janelle Bradley
