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Hematologic Malignancy Episodes Exceed Target Price in Oncology Care Model.

Jennifer Nguyen1, Vittorio Maio1,2, Karen Walsh1

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Most hematologic malignancy episodes in the Oncology Care Model (OCM) exceeded their target prices. Factors like Part B/D drug use and novel therapies contributed to the significant total cost of care (TCOC) misalignment.

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Area of Science:

  • Oncology
  • Health Economics
  • Healthcare Policy

Background:

  • The Oncology Care Model (OCM) aims to improve cancer care quality and reduce costs.
  • Understanding cost drivers and target price alignment is crucial for OCM success, particularly in hematologic malignancies.

Purpose of the Study:

  • To evaluate the alignment between total cost of care (TCOC) and target price in OCM hematologic malignancy episodes.
  • To identify factors associated with episodes exceeding the target price.

Main Methods:

  • Analysis of hematologic malignancy episodes from OCM performance periods 1-4 reconciliation reports at a large academic medical center.
  • Statistical analysis to identify episode characteristics associated with exceeding target price.

Main Results:

  • Over half (54.8%) of the 516 analyzed hematologic malignancy episodes exceeded their target price.
  • Key factors associated with exceeding target price included Medicare Part B and Part D drug use, novel therapy use, home health agency involvement, and longer duration since last chemotherapy (>730 days).
  • The mean TCOC for episodes exceeding target price was significantly higher ($85,374) than the mean target price ($56,106).

Conclusions:

  • A substantial misalignment exists between TCOC and target price for hematologic malignancy episodes within the OCM.
  • This misalignment suggests potential inadequacies in the OCM target price adjustments for these complex patient populations.