Abstract PO-003: Multidisciplinary cancer care among breast, colorectal, and lung cancer patients: A SEER-Medicare analysis

2019 ◽

Vol 56 ◽

pp. 004695801988069 ◽

Cited By ~ 1

Author(s):

Joohyun Park ◽

Kevin A. Look

Keyword(s):

Lung Cancer ◽

Health Care ◽

Cancer Patients ◽

Cancer Care ◽

Health Care Expenditure ◽

Health Care Expenditures ◽

The United States ◽

Lung Cancer Patients ◽

Service Type ◽

Policies And Programs

Using nationwide data, this study estimated and compared annual health care expenditures per person between noncancer and cancer patients, and among patients with the 4 most common cancers. Two-part models were used to estimate mean expenditures for each group by source of payment and by service type. We found that cancer patients had nearly 4 times higher mean expenditures per person ($16 346) than those without cancer ($4484). These differences were larger among individuals aged 18 to 64 years than those ≥65 years. Medicare was the largest source of payment for cancer patients, especially among those ≥65 years. Among the 4 most common cancers, the most costly cancer was lung cancer. Ambulatory care visits accounted for the majority of health care expenditures for those with breast cancer, while for those with other cancers, inpatient services also contributed to a significant portion of expenditures especially among younger patients. This study demonstrates that cancer patients experience a substantially higher health care expenditure burden than noncancer patients, with lung cancer patients having the highest expenditures. Expenditure estimates varied by age group, source of payment, and service type, highlighting the need for comprehensive policies and programs to reduce the costs of cancer care.

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Total cost of lung cancer care associated with broad panel versus narrow panel sequencing.

Journal of Clinical Oncology ◽

10.1200/jco.2020.38.15_suppl.7077 ◽

2020 ◽

Vol 38 (15_suppl) ◽

pp. 7077-7077

Author(s):

Rogelio Alberto Brito ◽

Bob Cullum ◽

Kevin Hastings ◽

Elisea Avalos-Reyes ◽

Rebecca Karos ◽

...

Keyword(s):

Lung Cancer ◽

Cancer Patients ◽

Cancer Care ◽

Lung Tumor ◽

Progression Free Survival ◽

Cost Of Care ◽

Total Cost ◽

Lung Cancer Patients ◽

Genomic Test ◽

Panel Sequencing

7077 Background: Many lung cancer patients are diagnosed late with advanced or metastatic disease. Targeted therapies can improve quality of life and increase the chances of progression-free survival versus conventional treatments. An understanding that there may be more than one driver mutation associated with a specific lung tumor is crucial for the timing and delivery of the most effective line of therapy. Broad panel sequencing (BPS) minimizes tissue use and enables personalized treatment that decreases the use of ineffective agents and unwarranted side effects, in addition to opening pathways to early clinical trials. However, many payors do not reimburse for BPS. The objective of this study was to determine if BPS leads to lower total cost of care versus narrow panel sequencing (NPS). Methods: We identified new lung cancer patients who completed BPS (Current Procedural Terminology (CPT) code 81455, 51+ genomic test) or NPS (CPT code 81445, 5-50 genomic test) using medical claims from January 1, 2018, to March 31, 2019. We defined total cost of care as allowed costs paid for medical and pharmacy claims across a six-month time period from the first gene sequencing panel. We also compared the allowed costs of BPS and NPS. A Student’s t-test was used to compare differences and results are presented as mean +/- standard deviation. Results: From January 2018 to March 2019, we identified 45 patients who underwent BPS sequencing and 399 patients who underwent NPS. The average BPS cost was $1,977 +/- $2,713 versus the average NPS lab cost $719 +/- $1,087, p < 0.0001. The average 6-month per member per month (PMPM) total cost was $11,535 +/- $9,168 among those who underwent BPS compared to $20,039 +/-19,642 in those who underwent NPS. This difference of $8,504 was statistically significant, p = 0.0022. Conclusions: BPS has been shown to optimize treatments in patients with lung cancer. These initial results of claims suggest that while lung cancer patients undergoing BPS have higher total sequencing costs than those undergoing NPS, BPS significantly reduces overall total cost of lung cancer care. Identifying the broader genomic landscape of a patient’s tumor earlier will empower oncology providers and lung cancer patients with information to make timely, precise treatment decisions that are ultimately more cost effective.

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Abstract C47: Hispanic/Latino lung cancer patients overcoming barriers for accessing cancer care: A qualitative study

10.1158/1538-7755.disp13-c47 ◽

2014 ◽

Author(s):

William Alago ◽

Elyse Shuk ◽

Ana-Motta Moss ◽

George Brandon ◽

Abraham Aragones ◽

...

Keyword(s):

Lung Cancer ◽

Qualitative Study ◽

Cancer Patients ◽

Cancer Care ◽

Lung Cancer Patients

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Understanding differences in total cancer care cost by service site.

Journal of Clinical Oncology ◽

10.1200/jco.2019.37.15_suppl.e18345 ◽

2019 ◽

Vol 37 (15_suppl) ◽

pp. e18345-e18345

Author(s):

Karen K. Fields ◽

Jason M Burkett ◽

Cindy Terrano ◽

Floyd Dukes ◽

Bharat Gorantla ◽

...

Keyword(s):

Lung Cancer ◽

Cancer Treatment ◽

Cancer Patients ◽

Cancer Care ◽

Early Stage ◽

Peer Group ◽

Peer Groups ◽

Total Cost ◽

Lung Cancer Patients ◽

One Year

e18345 Background: Oncology providers are under mounting pressure to deliver high quality and increasingly complex cancer treatment while simultaneously managing the cost pressures coming from payers and patients alike. Developing an effective strategy to compare costs can be an important tool for assessing and improving performance and cost effectiveness from both a clinical and market competitive standpoint. This comparison can be difficult to achieve in practice, especially between different sites of care and across heterogeneous patient populations. Methods: A large commercial claims dataset with reimbursement data for claims incurred between 2014 and 2017 was used to identify lung cancer patients by site of care. We calculated average annual total cost of care (TCC) for a one year period for patients with a new cancer diagnosis following a one year period of no claims for lung cancer. For study purposes, Moffitt Cancer Center (MCC) was compared to two other peer groups: Large Hospital Systems (LHS) and small hospitals and community-based oncology practices (CBOP). Patients were assigned to each peer group when a majority of claims ( > 70%) were attributed to one of the peer groups. We analyzed overall average annual TCC for all patients and then created a sub-cohort of patients who received surgery within the study period to define early stage patients based on known standard patterns of care for newly diagnosed lung cancer. Results: There were 1249 new lung cancer patients in the study across all three peer groups with an average annual TCC of $134K per patient (range: $110K to $149K). When considering the sub-cohort of early stage patients (n = 396), MCC’s average annual TCC was $124K per patient which was significantly lower than LHS ($152K; p < 0.0499) and CBOP ($167K; p < 0.01). Conclusions: Although claims data generally contain only limited clinical information such as procedures, supplies and diagnosis, this limitation can be address by incorporating known standard of care patterns for cancer treatment to create comparable groups. Using this approach, national claims sets can be leveraged as the basis of a powerful analysis tool for understanding the Total Cost of Cancer care across institutional boundaries while still achieving meaningful comparability of the analyzed patient population.

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Patient and caregiver’s satisfaction with multidisciplinary vs. serial lung cancer care in a community setting.

Journal of Clinical Oncology ◽

10.1200/jco.2020.39.28_suppl.200 ◽

2021 ◽

Vol 39 (28_suppl) ◽

pp. 200-200

Author(s):

Huibo Shao ◽

Nicholas Faris ◽

Meghan Brooke Taylor ◽

Carrie Fehnel ◽

Anita Patel ◽

...

Keyword(s):

Lung Cancer ◽

Cancer Patients ◽

Cancer Care ◽

Care Delivery ◽

Financial Burden ◽

Treatment Plan ◽

Hospital System ◽

Team Members ◽

Lung Cancer Patients

200 Background: Few existing studies examined lung cancer patients and caregivers’ satisfaction with the team-based multidisciplinary care (MD) in comparison to the usual serial care (SC). We hypothesized that MD, by providing early and concurrent input from key specialists collaborating as a team with patients and caregivers to develop a consensus care plan, can improve patients and caregivers’ satisfaction with care, compared to SC, in which multiple specialists independently screen, diagnose, and treat patients through a fragmented sequence of referrals. Methods: Data on newly diagnosed lung cancer patients, enrolled in a prospective matched cohort comparative effectiveness trial of MD or SC between Oct. 9th, 2014 and July 5th, 2017 in a Mid-South community hospital system, were collected at baseline, 3- and 6-month periods to assess patient and caregiver’s satisfaction with these two care-delivery models. Measures of satisfaction were adapted from the Consumer Assessment of Healthcare Providers and Systems (CAHPS) survey. Multivariate mixed linear models were used to examine the cross-group differences, the time-related variances, and how the interaction between groups and time-periods influenced patients’ and caregivers’ satisfaction. Results: Compared with SC (N = 297), patients in MD (N = 159) were older (66 vs. 69 years), more in an early cancer stage (33% vs. 41% in stage I or II), and lower in performance score (35% vs. 45% asymptomatic). Demographic and social-economic characteristics of caregivers in MD (N = 97) and SC (N = 122) were not significantly different. Patients and caregivers in MD were more likely than those in SC to perceive their care to be better than that received by other patients (p =.003 and p <.001 respectively). Greater satisfaction with their treatment plan at 6-month was observed among the MD patients (p =.004). Also, MD patients reported better overall satisfaction with team members (p =.038). Consistent with the findings among the patients in MD, caregivers in MD were more satisfied with the quality of care (p <.001) and with care received from team members (p <.001) than that reported by caregivers in SC. Conclusions: Coordinated MD care improved patients and caregivers’ satisfaction with lung cancer care in a community healthcare system. Further research will compare the quality of life and financial burden on patients in the MD and SC treatment models to provide more evidence for stakeholders to refine cancer care models.

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