Value-based care model for cancer patients improves outcomes and costs

Sept. 9, 2019
Study that utilized lay health workers saw significant reductions in patient-reported symptoms, acute care use and total costs of care

The Oncology Institute (TOI), in collaboration with the Stanford University School of Medicine and CareMore Health, has announced data from a study, “Enhancing community capacity to deliver value-based cancer care at the end-of-life,” which evaluated the effect of the intervention of using lay health workers (LHWs) on end-of-life cancer care.

Specifically, the study evaluated healthcare use in the last month of life and its impact on quality care and financial burden on patients. Results were presented at the 2019 ASCO Quality Care Symposium in San Diego, CA (Abstract #4).

The study enrolled CareMore patients newly diagnosed with solid and hematologic malignancies from November 2016 through September 2018 and compared outcomes to a control group of all patients diagnosed with cancer in the year prior to intervention. The value-based cancer care model utilized LHWs, which are non-physician members of the community who have received specialized training to support the patient care and navigation.

The study found there was no difference in survival between the groups, while the patients receiving the value-based care experienced better quality with end-of-life cancer care. The latter group had 40 percent lower inpatient admissions, 75 percent fewer emergency department visits in the last month of life, 45 percent increased hospice use, 40 percent fewer acute care facility deaths and 25 percent lower median total healthcare costs from diagnosis until death.

For all patients who died within 12 months, their risk of death was analyzed using Cox Models and generalized linear regression to compare healthcare use in the last month of life, and total costs of care from diagnosis until death. All models were adjusted for age, stage, comorbidities, diagnosis and length of follow-up.

“This study is another proof point that the patient-centric and comprehensive care model developed at Stanford and implemented by The Oncology Institute and CareMore Health is the direction that the medical oncology model should be going,” said Richy Agajanian, MD, Chief Medical Officer and Senior Regional Director at TOI. “We are excited to provide this model of care to patients nationally as we continue to expand our partnerships with health care systems such as CareMore that are seeking to improve patient care and lower financial burden on patients through value-based oncology care.”