151 Background: Accountable Care Organizations (ACOs) seek to promote high quality, coordinated care by eliminating unnecessary procedures, sharing clinical information, and meeting quality targets. Of the 65 proposed quality measures outlined in the Medicare Shared Savings Program (MSSP), only two relate specifically to cancer care, calling into question how such models will accelerate high quality care in oncology. Prostate cancer offers an insightful case study as it is characterized by a lack of consensus around diagnosis and treatment and the involvement of several providers throughout the care continuum. Methods: As part of a multi-layered analysis to evaluate the impact of the ACO model on quality improvement and the management and treatment of prostate cancer, Avalere examined recent legislation (e.g., the Affordable Care Act, MSSP) to identify key characteristics of the model. Avalere then reviewed the potential impact of these characteristics in oncology by examining clinical guidelines and reviewing public statements by key opinion leaders. After identifying gaps specifically related to prostate cancer, Avalere categorized the characteristics into three groups based on their potential impact on prostate cancer care: high, moderate, and low. Results: Our analysis yielded the following categorization of the ACO characteristics: High Impact: Streamlined coordination of care between facilities and providers Focus on high-risk, high-cost populations Moderate Impact: Emphasis on preventative health Standardized use of outcomes-based quality measures Low Impact: Improved medication continuity Chronic disease management Shared savings incentives Conclusions: As providers involved in prostate cancer care explore the ACO concept, it will be critical to identify the characteristics with the greatest potential to improve the quality and coordination of care, and to incorporate these characteristics into the guideline recommendations influencing the standard of care. Our research indicates that prostate cancer guidelines should emphasize the low quality and high cost of fragmented care in this patient population and develop recommendations on proven methods of care coordination and quality improvement.
Setting the Bar: Developing Quality Measures and Education Programs to Define Evidence-Based, Patient-Centered, High-Quality Care
