Jefferson College of Population Health, Thomas Jefferson University, Philadelphia, PA.
Asano-Gonnella Center for Research in Medical Education and Health Care, Sidney Kimmel Medical College, Philadelphia, PA.
Am J Med Qual. 2023;38(4):174-180. doi: 10.1097/JMQ.0000000000000127. Epub 2023 Jun 15.
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.
本研究评估了在肿瘤医疗模式(OCM)血液恶性肿瘤病例中,总医疗成本(TCOC)和目标价格是否一致,并确定了与超过目标价格相关的因素。从一家大型学术医疗中心的 OCM 绩效期间 1-4 对账报告中确定了血液恶性肿瘤病例。在纳入分析的 516 例血液恶性肿瘤病例中,283 例(54.8%)超过了目标价格。经统计学分析,与超过目标价格显著相关的病例特征包括:医疗保险 B 部分药物和 D 部分药物使用、新型治疗方法、家庭健康机构和最后一次化疗后>730 天。超过目标价格的病例的 TCOC 平均值为 85374 美元(±26342 美元),而目标价格的平均值为 56106 美元(±16309 美元)。研究结果发现血液恶性肿瘤病例的 TCOC 和目标价格之间存在严重的不匹配,这增加了关于 OCM 目标价格调整不足的现有证据。