Quality and cost outcomes of an integrated supportive care program

Area of Science:

• Oncology
• Palliative Care
• Health Services Research

Background:

• Advanced cancer presents complex challenges impacting quality of life and healthcare utilization.
• Supportive care models aim to improve patient outcomes and manage complex needs.
• The Center for Medicare and Medicaid Innovation (CMMI) funded a project to evaluate such a model.

Purpose of the Study:

• To assess the impact of a supportive care program on quality of care, quality of life, and costs for advanced cancer patients.
• To evaluate clinical benefits and economic implications of integrated supportive care.

Main Methods:

• A demonstration project enrolled adult Medicare/Medicaid beneficiaries with advanced solid tumors (February 2015-February 2018).
• Utilized a comparative longitudinal design with concurrent and historic controls.
• Intervention included electronic biopsychosocial screening, palliative care access, and nurse care coordination.

Main Results:

• 1340 patients enrolled; 71% Caucasian, 41.4% stage IV cancer.
• Intervention group showed significantly fewer ED visits, unplanned admissions, and hospitalization days.
• Improved quality of life, increased hospice enrollment in the last 30 days of life, with no cost reduction.

Conclusions:

• Integrated supportive care demonstrably benefits advanced cancer patients clinically, enhancing quality of life.
• While clinical benefits are confirmed, this project did not achieve cost savings.