权益分类	功能权益	普通用户	{{item.name}}会员
{{category.name}}	{{benefitItem.name}}

Aligning financial incentives to promote rational use of active surveillance for prostate cancer

调整财政激励措施以促进前列腺癌主动监测的合理使用

基本信息

批准号：
10592422
负责人：
BRENT K. HOLLENBECK
金额：
$ 55.94万
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：
2022
资助国家：
美国
起止时间：
2022-04-01 至 2027-03-31
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10592422
关键词：
Achievement Address Adverse effects Androgens Authorization documentation Biopsy Blue Cross Blue Shield Caring Characteristics Clinical Communities Cost Savings Data Development Diagnosis Disease Disincentive Ensure Goals Growth Healthcare Image Incentives Intensity-Modulated Radiotherapy Intervention Interview Life Expectancy Literature Magnetic Resonance Imaging Malignant Neoplasms Malignant neoplasm of prostate Measures Medicare Methods Michigan Modality Modeling Monitor Morbidity - disease rate Movement Natural History Operative Surgical Procedures Patient-Focused Outcomes Patients Performance Physicians Policies Practice Management Privatization Prostate Cancer therapy Provider Radiation therapy Registries Remunerations Review Literature Risk Savings Sexual Dysfunction Structure Symptoms System Testing Time Uncertainty Urologic Surgical Procedures Urologist Urology Variant aggressive therapy authority bundled payment care costs cost curative treatments deprivation disorder risk financial incentive genomic signature health care delivery implementation measures improved interest meetings men mortality mortality risk overtreatment payment population health prevent prostate cancer risk provider behavior response surveillance strategy treatment pattern tumor tumor progression urinary

项目摘要

Project Summary This project aims to address inherent financial disincentives for active surveillance for prostate cancer. Many men with favorable-risk disease will not benefit from aggressive intervention. The uncertainty surrounding who and how to treat has led to wide variation in treatment patterns, in part driven by nonclinical factors such as financial incentives. The strategy of surveillance, which avoids or delays aggressive treatment for men with favorable-risk tumors, has been shown to reduce treatment associated morbidity and spending, without compromising survival. As such, it is well aligned with the current national interest in improving the value of health care delivery. Yet studies demonstrate surveillance is underutilized and its implementation varies widely. There are several factors contributing to this, but one plausible contribution is the financial incentives for providers embedded within the delivery system that favor aggressive interventions, as their reimbursement is immediate and can be several-fold greater than for surveillance-related activities. Recent payment reforms encourage a movement to alternative payment models (APMs), intended to improve the value of health care. An APM in this context could provide additional payment to providers for performing surveillance, while tying reimbursement to achievement of quality targets that ensure its appropriate performance and lowering total payer costs. The objective of this proposal is to develop APMs to promote rational use of surveillance, with the following aims: 1) To understand urologist response to payment incentives for active surveillance; 2) To develop robust quality performance measures for implementation of active surveillance; and, 3) To develop and simulate the financial impact of alternative payment models for favorable-risk prostate cancer on payers and providers. Ultimately, APMs will align financial incentives for payers and providers, reduce unwarranted variation in implementation, and shift more men to appropriate use of surveillance thereby improving population health among men with favorable-risk prostate cancer.

项目总结