Outcome measures for oncology alternative payment models: practical considerations and recommendations

Area of Science:

• Oncology
• Health Services Research
• Quality Improvement

Background:

• Quality measures are crucial for evaluating and improving cancer care.
• Outcome-based quality measures are underutilized in oncology.
• Alternative payment models (APMs) in oncology require robust quality metrics.

Purpose of the Study:

• To synthesize existing scholarship on quality measures in oncology.
• To focus on outcome-based quality measures and their underutilization.
• To propose core outcome measures for future oncology APMs.

Main Methods:

• Focused literature review of oncology quality assessment frameworks.
• Content analysis of 142 quality metrics.
• Synthesis and categorization of outcome measures using the Center for Medicare and Medicaid Innovation APM toolkit.

Main Results:

• Identified 34 outcome-based oncology quality measures across 5 domains: clinical care, safety, care coordination, patient experience, and population health.
• Emphasized the need for both general and indication-specific outcome measures in oncology APMs.
• Highlighted challenges in implementing outcome-based measures, including risk adjustment and data quality.

Conclusions:

• A rigorous approach to quality assessment is essential for advancing oncology care.
• Effective oncology APMs depend on relevant, robust quality measures for patients, providers, and payers.