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

了解肿瘤护理模式对双重合格患者癌症护理的影响

基本信息

批准号：
10206065
负责人：
Lindsey Allison Herrel
金额：
$ 25.64万
依托单位：
UNIVERSITY OF MICHIGAN AT ANN ARBOR
依托单位国家：
美国
项目类别：
财政年份：
2019
资助国家：
美国
起止时间：
2019-07-01 至 2024-06-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10206065
关键词：
Accounting Adherence Cancer Burden Cancer Patient Caring Characteristics Colon Carcinoma Complex Control Groups Data Development Plans Diagnosis Elderly Evaluation Fees Fostering Goals Grant Guidelines Health Policy Health Services Health Services Accessibility Health system Hospitalization Improve Access Incentives Information Technology Lead Low income Malignant Neoplasms Malignant neoplasm of lung Malignant neoplasm of prostate Measures Medicaid Medical Medicare Medicare claim Medicare/Medicaid Mentors Methodology Methods Modeling Modification Motivation Oncologist Oncology Operative Surgical Procedures Outcome Patients Performance Physicians Policies Policy Analysis Population Provider Quality of Care Research Research Personnel Resources Rewards Risk Risk Adjustment Scientist Services Structure Surgeon Testing Training Translating United States Centers for Medicare and Medicaid Services Variant Voluntary Programs Vulnerable Populations Work base beneficiary cancer care care coordination care episode career career development chemotherapy cost design disparity reduction dual eligible econometrics ethnic minority population experience financial incentive health equity hospice environment improved improved outcome insight malignant breast neoplasm medical specialties multiple chronic conditions payment programs racial minority simulation skills social success urologic

项目摘要

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.

项目概要/摘要候选人：Lindsey Herrel，医学博士、理学硕士，泌尿肿瘤科医生和初级卫生服务人员研究人员致力于通过卫生政策改善弱势群体的癌症护理改革。 Herrel 博士的长期职业目标是成为一名独立的外科医生兼科学家评估影响癌症弱势群体的医疗保健政策，并能够通过医疗保健政策改革转化研究成果。研究背景：每年有近 900,000 名医疗保险受益人被诊断患有癌症，成本超过340亿美元。肿瘤护理模式，这是第一种选择癌症的支付模式，激励医生以更低的成本提供更高质量的护理。对于因老年身份而有资格获得 Medicare 和到期 Medicaid 的双重资格受益人针对低收入，诸如 OCM 之类的计划奖励质量改进和减少通过护理协调支出，可能会提供一个独特的机会来改善癌症护理这些弱势群体。然而，该计划也可能导致逆向选择和如果财政激励措施没有适当调整，获得机会就会受到限制。具体目标： 1) 更好地了解双轨制 OCM 参与实践水平的变化合格的受益人。 2) 检查 OCM 参与对癌症护理质量的影响以及双打的支出。 3) 评估替代支付策略对癌症的影响照顾双重合格受益人。研究计划：Herrel 博士将使用与当前一致的医疗保险索赔和方法政策来描述参与 OCM 的做法，特别是在双重接受的情况下癌症护理。然后，她将使用先进的计量经济学方法来评估该计划的效果 OCM 关于提高双打质量和减少支出的政策。最后，她将决定是否当前的经济激励措施与照顾双子女适当一致，并将评估是否可以替代支付策略可能会为照顾双子女提供更大的动力。职业发展计划：与本研究计划并行并在良好的指导下 Herrel 博士将在以下领域发展专业知识：1) 弱势群体的健康公平人口和双重合格受益人； 2) 卫生政策的立法和监管方面； 3）用于政策评估和模拟的高级计量经济分析。