The oncology care model (OCM) may be a successful approach for implementing value-conscious care, according to results of a study published in the Journal of Clinical Oncology.
Supportive care medications are important aspects to cancer care but can be costly. Use of these medications does not typically consider cost, and as such, the American Society of Clinical Oncology (ASCO) has explicitly recognized the overuse of costly supportive care medications. OCM is an episode-based alternative payment model designed to reduce Medicare spending for cancer care while maintaining quality of care.
This study sourced Medicare beneficiaries fee-for-service claims data between 2014 and 2019 to assess use of supportive care medications. Claims were stratified between practices participating in OCM (n=201) and nonparticipating practices (n=534). Using a propensity matching approach, researchers assessed differences in use of bone-modifying medications (255,638 treatment episodes), prophylactic white blood cell (WBC) growth factors (164,310 beneficiary episodes), and prophylactic antiemetics (414,792 treatment episodes).
OCM associated with decreased use of bone-modifying medications among patients with breast cancer (relative reduction [RR], -5.0%; P ≤.01), prostate cancer (RR, -4.0%; P ≤.01), and lung cancer (RR, -4.1%; P ≤.05).
For WBC growth factors, there was little effect of the OCM on use except for during intermediate-risk breast cancer chemotherapy episodes (difference-in-difference [DID] impact, -7.6%).
The antiemetic analysis found a decrease in neurokinin-1 and long-acting serotonin antagonists among patients at high risk during chemotherapy episodes (DID impact, -6.0%).
This study may have been limited by not having access to data about the appropriateness of therapies prescribed.
These data indicated that the OCM led to a modest but clinically significant change in use of some classes of supportive care medications, suggesting that alternative payment models may drive value-based changes in supportive cancer care.
Disclosure: Multiple authors declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original article for a full list of authors’ disclosures.
Brooks GA, Landrum MB, Kapadia NS, et al. Impact of the oncology care model on use of supportive care medications during cancer treatment. J Clin Oncol. February 25, 2022. doi:10.1200/JCO.21.02342