Understanding the effects of the Oncology Care Model on cancer care for dual eligible patients

项目摘要/摘要 候选人：林赛·赫雷尔，医学博士，医学硕士，泌尿外科肿瘤学家和初级卫生服务部 研究人员专注于通过卫生政策改善对弱势人群的癌症护理 改革。赫雷尔医生的长期职业目标是成为一名独立的外科医生-科学家 评估影响患癌症的弱势人群的医疗保健政策，有能力 通过医疗政策改革转化研究成果。 研究背景：每年有近90万名联邦医疗保险受益人被诊断患有癌症， 耗资超过340亿美元。肿瘤学护理模式，这是第一选择 癌症的支付模式，激励医生以较低的成本提供更高质量的护理。 对于因老年人身份和医疗补助到期而有资格享受联邦医疗保险的双重符合资格的受益人 对于低收入者，像OCM这样奖励质量提高和减少的计划 通过护理协调进行支出，可能为改善癌症护理提供独特的机会 这些脆弱的人群。然而，这一计划也可能导致逆向选择和 如果财政激励措施没有适当地协调一致，机会就会受到限制。 具体目标：1)更好地了解双人OCM参与的实践水平差异 符合条件的受益人。2)研究OCM参与对癌症护理质量的影响 以及二重唱的花销。3)评估替代支付策略对癌症的影响 照顾符合条件的双重受益人。 研究计划：Herrel博士将使用与当前一致的联邦医疗保险声明和方法 描述参与OCM的实践的政策，特别是在双人接受 癌症护理。然后，她将使用先进的计量经济方法来评估 OCM关于提高双打质量和减少开支的政策。最后，她将决定是否 目前的财政激励措施与照顾双胞胎适当地结合在一起，并将评估是否可以替代 支付策略可能会提供更大的动机来照顾双胞胎。 职业发展计划：与本研究计划并行，并在Well- 作为可靠的导师，赫雷尔博士将在以下方面发展专业知识：1)弱势群体的健康公平 人口和双重符合条件的受益人；2)保健政策的立法和监管方面； 3)高级计量经济学分析，用于政策评估和模拟。

PROJECT SUMMARY/ABSTRACT Candidate: Lindsey Herrel, MD, MS is a urologic oncologist and junior health services researcher focused on improving cancer care for vulnerable populations through health policy reform. Dr. Herrel's long-term career goal is to become an independent surgeon-scientist evaluating healthcare policies that impact vulnerable populations with cancer, with the ability to translate research findings through healthcare policy reform. Research Context: Nearly 900,000 Medicare beneficiaries are diagnosed with cancer annually, with costs exceeding $34 billion. The Oncology Care Model, which is the first alternative payment model in cancer, incentivizes physicians to provide higher quality care at a lower cost. For dual eligible beneficiaries who qualify for Medicare due to elderly status and Medicaid due to low income, programs such as OCM that reward improvements in quality and reductions spending through care coordination, may offer a unique opportunity to improve cancer care for these vulnerable populations. However, this program may also lead to adverse selection and limited access if financial incentives are not properly aligned. Specific Aims: 1) To better understand practice level variation in OCM participation for dual eligible beneficiaries. 2) To examine the effect of OCM participation on quality of cancer care and spending for duals. 3) To evaluate the impact of alternative payment strategies on cancer care for dual eligible beneficiaries. Research Plan: Dr. Herrel will use Medicare claims and methodology consistent with current policy to characterize practices participating in OCM, in particular where duals are receiving cancer care. She will then use advanced econometric methods to evaluate the effect of the OCM policy on improving quality and reducing spending for duals. Finally, she will determine if current financial incentives are properly aligned with caring for duals and will assess if alternate payment strategies may provide greater motivation to care for duals. Career Development Plan: In parallel with this research plan and under the guidance of well- established mentors, Dr. Herrel will develop expertise in: 1) health equity for vulnerable populations and dual eligible beneficiaries; 2) legislative and regulatory aspects of health policy; 3) advanced econometric analyses for policy evaluation and simulation.