Reducing Cancer Costs Through Symptom Management and Triage Pathways

Abstract

Confounding Factor(S), Drawbacks: Certain limitations to the study are acknowledged. We have attempted to identify events that did not actually occur, although we are confident that the methodology used to identify the ER nonevents was rigorous and highly reliable. Our study consists of a small sample size exacerbated by evaluating small (6% to 7%) changes in ER visits over a short study period, thus limiting our ability to confirm statistical significance in the reduction in ER events. Limitations inherent in the OCM claims data did not allow for rigorous risk adjustments for patient comorbidities, which can potentially impact findings. We have relied on the findings of others to determine the cost ratio of commercial costs to Medicare costs for the same service, which could impact the accuracy of the total savings among commercial patients. Finally, we recognize that medical practices incur operating expenses in providing these services and pathways and that such expenses would be a deduction from any economic gain to the practices resulting from their programs. Real-Life Implications: To demonstrate the value in value-based care, reliable quantification of economic impacts is a critical component. In this study, we have developed a methodology and approach to quantify the economic impacts of symptom management and triage pathways, which may have broader application in the continuing pursuit of value-based care and in the negotiation of the alternative payment models associated with such care.