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.

项目概要/摘要 NCI K08职业发展建议的总体目标是促进Miranda Lam博士发展成为一名肿瘤学卫生政策研究的独立研究者专注于了解影响肿瘤学的因素和政策她提出的项目旨在描述放射肿瘤学支出的变化，美国各地的利用率和质量，并确定高价值放射肿瘤学实践所使用的策略。主要目标是 1) 识别并描述放射肿瘤学支出、利用和质量的变化对于接受放射治疗的癌症患者，2）专门调查支出、利用和治疗方面是否存在差异放射肿瘤学的质量适用于具有双重资格的患者，这些患者年龄较大，享受医疗保险，而低收入或残疾人则享受医疗保险医疗补助，3) 阐明高价值实践与低价值实践所使用的方法和策略。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美国各地通过放射治疗提供癌症护理确定护理方法和治疗方法的差异高价值实践与低价值实践所遇到的障碍对于医生、患者、医院领导和人员来说至关重要政策制定者目前的强制性放射肿瘤替代支付模式 (RO APM) 是由中心制定的。医疗保险和医疗补助 (CMS) 被搁置，替代支付和交付模式正在影响肿瘤学该项目。将及时为 CMS 和实践提供有价值的数据，以调整或通知未来的任何 APM，因为即使目前的形式，也是确保成功过渡而不会对癌症护理质量产生负面影响所必需的。 RO APM 的具体内容目前尚未实施，但仍需要了解高价值和低价值实践的差异对于确定某些实践是否需要额外支持以继续为其提供高价值护理很有价值癌症患者。在拟议研究的目标 1 中，研究者将分析医疗保险索赔数据，以描述她将系统地研究接受癌症放射治疗的患者的支出、利用率和质量。并全面评估放射肿瘤学实践，在目标 2 中，她将深入研究放射肿瘤学实践是否存在差异。最后，在目标 3 中，她将进行关键信息访谈。高价值和低价值实践，以阐明管理、领导力和护理服务方面的差异。