Assessing Variation in Outcomes for Cancer Patients Receiving Radiation Treatments and Identifying High-Value Radiation Oncology Practices

项目总结/摘要 这份NCI K 08职业发展建议书的总体目标是帮助米兰达博士发展成为一名 肿瘤学健康政策研究的独立调查员，专注于了解影响癌症的因素和政策。 癌症护理的质量和成本。她提出的项目旨在描述放射肿瘤学支出的变化， 利用率和质量，并确定高价值放射肿瘤学实践所使用的策略。 主要目的是1）识别和表征放射肿瘤学支出、利用和质量的变化 对于接受放射治疗的癌症患者，2）特别调查是否存在支出，利用和 放射肿瘤学的质量存在于双重资格的患者，他们是老年人的医疗保险和低收入或残疾人， 医疗补助，3）阐明高价值与低价值实践所使用的方法和策略。综合评价 分析放射肿瘤学实践的支出、利用和质量的变化是优化的第一步， 癌症护理提供与放射治疗在美国各地确定的差异，以照顾和 高价值实践与低价值实践所遇到的障碍对医生、患者、医院领导和 政策制定者。虽然目前的强制性放射肿瘤替代支付模式（RO APM）由中心， 医疗保险和医疗补助（CMS）暂停，替代支付和交付模式正在影响肿瘤学。这个项目 将及时为CMS和实践提供有价值的数据，以调整或告知未来的任何APM， 这是确保成功过渡而不对癌症护理质量产生负面影响所必需的。即使目前的形式 目前尚未实施RO APM，但仍将无法了解高价值和低价值做法的差异 确定某些做法是否需要额外的支持，以继续为他们提供高价值的护理， 癌症患者。 在拟议研究的目标1中，研究者将分析医疗保险索赔数据，以描述 接受癌症放射治疗的患者的花费、利用和质量。她将系统地 全面评估放射肿瘤学实践。在目标2中，她将深入研究 费用、利用率和质量。最后，在目标3中，她将进行关键线人访谈 高价值和低价值的做法，以阐明在管理，领导和护理提供的差异。

Project Summary/Abstract The overall goal of this NCI K08 career development proposal is to facilitate Dr. Miranda Lam’s development into an independent investigator in oncology health policy research focused on understanding factors and policies that impact the quality and cost of cancer care. Her proposed project aims to characterize the variation in radiation oncology spending, utilization, and quality across the U.S. and identify strategies used by high-value radiation oncology practices. The primary objectives are to 1) identify and characterize variation in radiation oncology spending, utilization, and quality for cancer patients undergoing radiation therapy, 2) specifically investigate whether disparities in spending, utilization and quality of radiation oncology exist for dual-eligible patients, who are older on Medicare and low-income or disabled on Medicaid, and 3) elucidate approaches and strategies used by high- vs. low-value practices. A comprehensive evaluation and analysis of variation in spending, utilization, and quality of radiation oncology practices is the first step to optimizing cancer care delivery with radiation treatments across the U.S. Identifying the differences in approaches to care and barriers encountered by high- vs low-value practices are critically important for physicians, patients, hospital leaders, and policymakers. While the current mandatory Radiation Oncology Alternative Payment Model (RO APM) by Centers for Medicare and Medicaid (CMS) is on hold, alternative payment and delivery models are impacting oncology. This project will be timely and provide CMS and practices with valuable data to adjust or inform any future APMs in the future, as necessary to ensure successful transition without negatively impacting the quality of cancer care. Even if the current form of the RO APM is not implemented at this time, understanding variation in high- and low-value practices will still be valuable to determine whether certain practices need additional support to continue to provide high-value care for their cancer patients. In Aim 1 of the proposed study, the investigator will analyze Medicare claims data to characterize the variation in spending, utilization, and quality for patients undergoing radiation therapy for cancer treatments. She will systematically and comprehensively evaluate radiation oncology practices. In Aim 2, she will delve into whether there are differences in spending, utilization, and quality for dual-eligible patients. Finally, in Aim 3, she will perform key informant interviews of high- and low-value practices to elucidate differences in management, leadership, and care delivery.