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Updated: Mar 6, 2026
08:41
Modeling Chemotherapy Resistant Leukemia In Vitro
Published on: February 9, 2016
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Global Budget Revenue Model and Care for Patients Receiving Chemotherapy
Yu-Li Lin1, Bradley Herring2,3, Alexander Melamed4
1Department of Health Services Research, University of Texas MD Anderson Cancer Center, Houston.
JAMA Network Open
|March 5, 2026
Summary
Maryland's Global Budget Revenue (GBR) model reduced Medicare payments for cancer care by 6.1% and hospitalizations by 1.7 percentage points. Savings were achieved by shifting care to lower-cost settings.
Area of Science:
- Health economics
- Oncology care delivery
- Healthcare policy
Background:
- Maryland's Global Budget Revenue (GBR) model aimed to control healthcare costs and improve quality through fixed global payments.
- The impact of the GBR model on cancer care, particularly for Medicare beneficiaries receiving systemic therapy, required robust evaluation.
Purpose of the Study:
- To assess the association between Maryland's GBR model implementation and changes in Medicare payments, hospital utilization, and quality of care for cancer patients.
- To compare outcomes in Maryland post-GBR implementation with control states using a difference-in-differences approach.
Main Methods:
- A cohort study design comparing pre-GBR (2011-2013) and post-GBR (2014-2018) periods.
- Analysis of six-month care episodes for Medicare beneficiaries receiving systemic anticancer therapy.
- Utilized Medicare claims data and a difference-in-differences analysis comparing Maryland to 11 control states.
Main Results:
- GBR implementation was linked to a 6.1% reduction in total episode payments and a 17.3% reduction in hospital payments.
- Professional payments increased by 11.9%, while chemotherapy-related hospitalizations decreased by 1.7 percentage points.
- No significant associations were observed for other utilization or quality of care measures.
Conclusions:
- Maryland's GBR model demonstrated significant reductions in Medicare payment growth for systemic anticancer therapy episodes.
- Observed savings may be attributed to a shift in care delivery towards more cost-effective settings.
- The GBR model offers insights into value-based healthcare payment reforms in oncology.
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