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

评估接受放射治疗的癌症患者的结果变化并确定高价值的放射肿瘤学实践

基本信息

批准号：
10663647
负责人：
Miranda Lam
金额：
$ 27.03万
依托单位：
BRIGHAM AND WOMEN'S HOSPITAL
依托单位国家：
美国
项目类别：
财政年份：
2023
资助国家：
美国
起止时间：
2023-05-01 至 2027-04-30
项目状态：
未结题

项目摘要

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.

项目摘要/摘要 NCI K08职业发展计划的总体目标是促进Miranda Lam博士的发展肿瘤卫生政策研究的独立研究者的重点是理解影响的因素和政策癌症护理的质量和成本。她提出的项目旨在表征辐射肿瘤学支出的变化，美国的利用和质量，并确定高价值辐射肿瘤学实践使用的策略。主要目标是1）识别和表征辐射肿瘤学支出，利用率和质量的变化对于接受放射疗法的癌症患者，2）特别研究支出，利用率和双重资格的患者存在辐射肿瘤学的质量，这些患者在医疗保险和低收入方面年龄较大或在医疗补助和3）阐明高价值与低价值实践使用的方法和策略。全面评估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在美国各地使用辐射治疗的癌症护理分娩，确定了护理方法的差异高价值实践遇到的障碍对于医生，患者，医院领导和决策者。而当前的强制辐射肿瘤学替代支付模型（RO APM）是中心的 Medicare和Medicaid（CMS）被搁置，替代付款和交付模式正在影响肿瘤学。这个项目将是及时的，并为CMS和实践提供有价值的数据，以调整或告知将来的任何APM，因为确保成功过渡的必要条件，而不会对癌症护理的质量产生负面影响。即使当前形式目前尚未实施RO APM，了解高价值和低价值实践的差异仍将是值得确定某些实践是否需要额外支持才能继续为其提供高价值护理的价值癌症患者。在拟议的研究的目标1中，研究人员将分析Medicare索赔数据以表征接受放射治疗的癌症治疗的患者的支出，利用和质量。她会系统地并全面评估辐射肿瘤学实践。在AIM 2中，她将深入研究是否存在差异双重资格患者的支出，利用和质量。最后，在AIM 3中，她将进行关键的线人访谈高价值和低价值实践，以阐明管理，领导和护理交付的差异。