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Reducing Spending Under Alternative Pay Models

J Oncol Pract; ePub 2017 Oct 5; Rocque, et al

Success for oncologists under alternative payment models is heavily driven by their ability to control antineoplastic drug spending and hospital use, researchers concluded after conducting a retrospective cohort study involving nearly 5,000 individuals. Participants were ≥65 years of age with primary fee-for-service Medicare insurance. They received antineoplastic therapy at 12 southeastern cancer centers between 2012 and 2014. Investigators looked at spending prechemotherapy and during Oncology Care Model episodes of care that led to antineoplastic therapy. They specifically assessed spending/episode, as well as spending by type of service. Among the results:

  • Average spending in the first, second, and third episodes of care was ~$34,000, ~$24,000, and ~$19,000, respectively.
  • Antineoplastic drugs accounted for 27%, 32%, and 36% of spending, respectively.
  • 10 medications—used by 31% of patients—represented 61% of the drug spend in the first episode.
  • Inpatient spending accounted for 17% to 20% of total spending.

Citation:

Rocque G, Williams C, Kenzik K, et al. Where are the opportunities for reducing health care spending within alternative payment models? [Published online ahead of print October 5, 2017]. J Oncol Pract. doi:10.1200/JOP.2017.024935.

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