Evaluating the Impact of Patient-Centered Oncology Care

NCT ID: NCT02110758

Last Updated: 2021-03-09

Basic Information

• Recruitment Status: COMPLETED
• Total Enrollment: 125250 participants
• Study Classification: OBSERVATIONAL
• Study Start Date: 2014-02-28
• Study Completion Date: 2017-01-31

Brief Summary

The National Committee for Quality Assurance has worked with the National Coalition for Cancer Survivorship, the American Society of Clinical Oncology, Oncology Management Services, Independence Blue Cross, and RAND, as well as a broader multi-stakeholder advisory group, to define the Patient-Centered Oncology Care model. The purpose of this project was to pilot and evaluate this model. Specific research questions were:

1. Does Patient-Centered Oncology Care improve patient experiences and quality of care? Does it reduce undesirable events like emergency department visits and hospital stays?

2. How does adoption of Patient-Centered Oncology Care vary across a variety of practices and what factors affect adoption?

The demonstration occurred in oncology practices in southeastern Pennsylvania. Practices received implementation support during the 24-month demonstration period. They were evaluated using patient surveys, quality measures, and measures of emergency department and hospital use. Results from these practices were compared in two ways: 1) with their performance before they became oncology medical homes and 2) with other similar practices.

Detailed Description

Background. Advances in cancer treatment mean that a growing number of Americans are living with cancer and experiencing it as a chronic, long-term condition. National panels led by consumers have identified the need for improved cancer care in the areas of communication between providers and patients and their families, care planning, attention to nonmedical needs, care coordination and provision of evidence-based treatment. The patient-centered medical home (PCMH) model of care is being widely adopted as a way to provide accessible, proactive, coordinated care and self-care through primary care practices. During active treatment for cancer, the oncology practice is often the primary setting supporting the patient and coordinating cancer treatment. By implementing the patient-centered medical home model, an innovative oncology practice in Pennsylvania has been able to improve access and reduce emergency department visits and hospitalizations for its patients.

Objectives. Building on these recommendations and experience, the National Committee for Quality Assurance has worked with the National Coalition for Cancer Survivorship, the American Society of Clinical Oncology, Oncology Management Services, Independence Blue Cross, and RAND, as well as a broader multi-stakeholder advisory group, to define the Patient-Centered Oncology Care model. We sought PCORI support to pilot and evaluate this model. Specific research questions were:

1. Does Patient-Centered Oncology Care improve patient experiences and quality of care? Does it reduce undesirable events like emergency department visits and hospital stays?

2. How does adoption of Patient-Centered Oncology Care vary across a variety of practices and what factors affect adoption?

Methods. The demonstration occurred in 5 oncology practices in southeastern Pennsylvania. Practices received implementation support during the 24-month demonstration period. They were evaluated using patient surveys, quality measures, and measures of emergency department and hospital use. Results from these practices were compared in two ways: 1) with their performance before they became oncology medical homes and 2) with other similar practices. Patients, clinicians, and health plan leaders helped design the project, and disseminate results. The project used Patient Centered Outcomes Research Institute (PCORI) resources efficiently by building on ongoing efforts. Our evaluation consisted of a retrospective, pre-post study design with a concurrent non-randomized control group of 18 local practices for the utilization and patient experience outcomes. We used difference-in-difference regression models that accounted for practice-level clustering and used functional forms appropriate to the dependent variables. For quality, we compared baseline and follow-up pilot practice performance to national and regional benchmark performance data.

Patient Outcomes. People with cancer are seeking high quality, coordinated and supportive care. The Patient-Centered Oncology Model has the potential to address current gaps in cancer care.

Conditions

Neoplasms

Study Design

• Observational Model Type: COHORT
• Study Time Perspective: PROSPECTIVE

Study Groups

Pilot Practices Patient Survey Cohort

Patients with any active drug therapy treatment for cancer receiving care at pilot practice in southeastern Pennsylvania

Pilot of Patient-Centered Oncology Care

Intervention Type: OTHER

Patient-Centered Oncology Care addresses six domains: track \& coordinate referrals, provide access and communication, identify and coordinate patient populations, plan and manage care, track \& coordinate care, and measure and improve performance.

Comparison Practices Patient Survey Cohort

Patients with any active drug therapy treatment for cancer receiving care at comparison practice in southeastern Pennsylvania

No interventions assigned to this group

Pilot Practices Utilization Cohort

Patients with an evaluation \& management claim attributed to a medical oncology pilot practice in southeastern Pennsylvania

Pilot of Patient-Centered Oncology Care

Intervention Type: OTHER

Patient-Centered Oncology Care addresses six domains: track \& coordinate referrals, provide access and communication, identify and coordinate patient populations, plan and manage care, track \& coordinate care, and measure and improve performance.

Comparison Practices Utilization Cohort

Patients with an evaluation \& management claim attributed to a medical oncology comparison practice in southeastern Pennsylvania

No interventions assigned to this group

Pilot Practices Quality Measures Cohort

Patients with a new diagnosis of cancer in the past two years

Pilot of Patient-Centered Oncology Care

Intervention Type: OTHER

Patient-Centered Oncology Care addresses six domains: track \& coordinate referrals, provide access and communication, identify and coordinate patient populations, plan and manage care, track \& coordinate care, and measure and improve performance.

Interventions

Pilot of Patient-Centered Oncology Care

Patient-Centered Oncology Care addresses six domains: track \& coordinate referrals, provide access and communication, identify and coordinate patient populations, plan and manage care, track \& coordinate care, and measure and improve performance.

Intervention Type: OTHER

Eligibility Criteria

Inclusion Criteria

Patients:

• Diagnosis of cancer
• Receives care at a pilot or comparison oncology practice located in southeastern Pennsylvania that accepts patients with Independence Blue Cross health insurance

• Minimum Eligible Age: 18 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

American Society of Clinical Oncology

OTHER

Sponsor Role: collaborator

Independence Blue Cross

OTHER

Sponsor Role: collaborator

National Coalition for Cancer Survivorship

UNKNOWN

Sponsor Role: collaborator

Oncology Management Services

UNKNOWN

Sponsor Role: collaborator

RAND

OTHER

Sponsor Role: collaborator

National Committee for Quality Assurance

OTHER

Sponsor Role: lead

Responsible Party

Responsibility Role: SPONSOR

Principal Investigators

Sarah H Scholle, DrPH, MPH

Role: PRINCIPAL_INVESTIGATOR

National Committee for Quality Assurance

Locations

National Committee for Quality Assurance

Washington D.C., District of Columbia, United States

Countries

United States

Other Identifiers

IH-12-11-4383

Identifier Type: -

Identifier Source: org_study_id