Hematologic Malignancy Episodes Exceed Target Price in Oncology Care Model.
Publication/Presentation Date
7-1-2023
Abstract
The current study evaluated whether total cost of care (TCOC) and target price were aligned in Oncology Care Model (OCM) hematologic malignancy episodes and identified factors associated with episodes exceeding target price. Hematologic malignancy episodes from OCM performance period 1-4 reconciliation reports were identified from a large academic medical center. Of the 516 hematologic malignancies episodes included in the analysis, 283 (54.8%) exceeded the target price. Episode characteristics found to be statistically significantly associated with exceeding target price were Medicare Part B drug use and Part D drug use, novel therapy use, home health agency, and >730 days from last chemotherapy. The mean TCOC was $85 374 (± $26 342) for the episodes that exceeded target price while the mean target price was $56 106 (±$16 309). The results found a substantial misalignment between the TCOC and target price for hematologic malignancy episodes, adding to the existing evidence on the lack of adequate adjustment to the OCM target price.
Volume
38
Issue
4
First Page
174
Last Page
180
ISSN
1555-824X
Published In/Presented At
Nguyen, J., Maio, V., Walsh, K., Handley, N., Patel, S., Keith, S. W., & Csik, V. P. (2023). Hematologic Malignancy Episodes Exceed Target Price in Oncology Care Model. American journal of medical quality : the official journal of the American College of Medical Quality, 38(4), 174–180. https://doi.org/10.1097/JMQ.0000000000000127
Disciplines
Business Administration, Management, and Operations | Health and Medical Administration | Management Sciences and Quantitative Methods
PubMedID
37314239
Department(s)
Administration and Leadership
Document Type
Article