Reducing Cancer Costs Through Symptom Management and Triage Pathways

Area of Science:

• Oncology
• Health Economics
• Healthcare Management

Background:

• Value-based care models emphasize high-quality, low-cost patient care.
• Reducing emergency room (ER) visits and hospitalizations is a key strategy in value-based oncology care.
• Previous studies indicated symptom management reduces ER events, but quantifying savings was challenging.

Purpose of the Study:

• To assess the impact of symptom management and triage programs on ER events and hospitalizations in community oncology practices.
• To quantify the financial savings generated by these programs for both Medicare and commercial patient populations.

Main Methods:

• Screening symptom management records from ER triage programs to identify avoided ER events.
• Validating findings with Medicare claim data from the Oncology Care Model.
• Utilizing bootstrap simulations to analyze statistical significance of ER event rate changes.

Main Results:

• An estimated 222 avoided ER events were identified, resulting in net annualized savings of $3.85 million for the two practices.
• While ER rate reduction was not statistically significant, results aligned with observed trends in Oncology Care Model beneficiaries.
• Calculated average event and total cost savings from avoided ER incidents and related hospitalizations.

Conclusions:

• Integrated platforms combining physician-scripted symptom management and telephone triage effectively reduce and quantify avoided ER events and hospitalizations.
• These programs offer a practical approach to achieving cost savings within value-based oncology care frameworks.
• Demonstrated financial benefits highlight the importance of proactive symptom management in cancer patient care pathways.