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.

项目概要该项目旨在解决主动监测前列腺癌的固有经济障碍。许多患有高危疾病的男性不会从积极的干预中受益。围绕谁的不确定性以及如何治疗导致了治疗模式的巨大差异，部分是由非临床因素驱动的，例如财政激励。监测策略，避免或延迟对男性患有这种疾病的积极治疗有利风险肿瘤，已被证明可以减少治疗相关的发病率和支出，而无需危及生存。因此，它符合当前提高物价价值的国家利益。医疗保健服务。然而研究表明，监测并未得到充分利用，其实施情况也存在很大差异。造成这一现象的因素有很多，但其中一个可能的因素是财政激励嵌入在交付系统中的提供商倾向于采取积极的干预措施，因为他们的报销是直接的，并且可能比监视相关活动大几倍。最近的支付改革鼓励转向替代支付模式（APM），旨在提高医疗保健的价值。在这种情况下，APM 可以向提供商提供额外的费用来执行监视，同时捆绑偿还质量目标的实现，确保其适当的绩效并降低总量付款人费用。该提案的目标是开发 APM 以促进监控的合理使用，以下目标： 1) 了解泌尿科医生对主动监测付费激励的反应； 2) 至制定强有力的质量绩效措施以实施主动监测；以及，3) 开发并模拟有利风险前列腺癌的替代支付模式对付款人的财务影响和提供商。最终，APM 将为付款人和提供者提供经济激励，减少不必要的支出实施方面的变化，并让更多的人适当使用监视，从而改善前列腺癌高危男性的人口健康状况。

项目成果

期刊论文数量（3）

专著数量（0）

科研奖励数量（0）

会议论文数量（0）

专利数量（0）

New technology in prostate cancer and financial toxicity.

前列腺癌和经济毒性的新技术。

DOI：
发表时间：
2023-09
期刊：
影响因子：
0
作者：
Maganty, Avinash;Hollenbeck, Brent K
通讯作者：
Hollenbeck, Brent K

Health care delivery system contributions to management of newly diagnosed prostate cancer.

医疗保健服务系统对新诊断的前列腺癌管理的贡献。

DOI：
发表时间：
2023-08
期刊：
影响因子：
4
作者：
Krampe, Noah;Kaufman, Samuel R;Oerline, Mary K;Hill, Dawson;Caram, Megan E V;Shahinian, Vahakn B;Hollenbeck, Brent K;Maganty, Avinash
通讯作者：
Maganty, Avinash

National Trends in Management of Newly Diagnosed Prostate Cancer.

新诊断前列腺癌管理的全国趋势。

DOI：
发表时间：
2024-04
期刊：
影响因子：
3.2
作者：
Maganty, Avinash;Kaufman, Samuel R;Oerline, Mary K;Lai, Lillian Y;Caram, Megan E V;Shahinian, Vahakn B;Hollenbeck, Brent K
通讯作者：
Hollenbeck, Brent K