Characteristics of medical oncologists participating in the Oncology Care Model.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. e18017-e18017
Author(s):  
Ravi Bharat Parikh ◽  
Justin E. Bekelman ◽  
Qian Huang ◽  
Joseph Martinez ◽  
Ezekiel J. Emanuel ◽  
...  
Keyword(s):  
Medical Training ◽  
Cross Sectional Study ◽  
Care Utilization ◽  
Care Model ◽  
Cross Sectional ◽  
Intensity Index ◽  
Physician Participation ◽  
Medical Oncologists ◽  
Oncology Care ◽  
Payment Models

e18017 Background: The Oncology Care Model (OCM) is Medicare’s first bundled payment program for patients with cancer. Because practices voluntarily enrolled in the OCM in 2016, there may be differences between OCM-participating and non-participating oncologists that impact the OCM’s generalizability. We examine baseline characteristics of OCM participants and markets with high OCM physician participation. Methods: In this cross-sectional study, we identified characteristics of US medical oncologists practicing in 2016 using a national telephone-verified physician database. We linked this data with Dartmouth Atlas and Medicare claims data to identify market characteristics of areas with high OCM participation. We used logistic regression to examine relationships between market characteristics and OCM participation. Results: Of 10428 US medical oncologists, 2605 (24.9%) were listed on an OCM-participating practice’s website. There were no differences in sex or medical training between OCM participants and non-participants, although OCM participants were younger. OCM participants were more likely to be affiliated with large, group, and urban practices that were not part of a health system (Table). Southwest, Southeast, and mid-Atlantic markets had higher OCM participation. Markets with high OCM physician participation had higher specialist density, Hospital Care Intensity Index, and acute care utilization at the end of life (all p < 0.001). Market penetration of Accountable Care Organizations (adjusted odds ratio [aOR] 4.65, 95% CI 3.31-6.56, p < 0.001) and Medicare Advantage (aOR 2.82, 95% CI 1.97-4.06, p < 0.001) were associated with higher OCM participation. Conclusions: We found differences in provider and practice demographics, care intensity, and prior exposure to alternative payment models between OCM-participants and non-participants. Differences in practice and market characteristics influence oncologists’ participation in alternative payment models and should be accounted for in Medicare’s OCM evaluation. [Table: see text]

scholarly journals Characteristics of Physicians Participating in Medicare’s Oncology Care Model Bundled Payment Program

2019 ◽  
Vol 15 (10) ◽  
pp. e897-e905 ◽  
Author(s):  
Ravi B. Parikh ◽  
Justin E. Bekelman ◽  
Qian Huang ◽  
Joseph R. Martinez ◽  
Ezekiel J. Emanuel ◽  
...  
Keyword(s):  
Odds Ratio ◽  
Adjusted Odds Ratio ◽  
Medical Training ◽  
Care Model ◽  
Cross Sectional ◽  
Bundled Payment ◽  
Practice Level ◽  
Physician Participation ◽  
Medical Oncologists ◽  
Oncology Care

PURPOSE: The Oncology Care Model (OCM) is Medicare’s first bundled payment program for patients with cancer. We examined baseline characteristics of OCM physician participants and markets with high OCM physician participation to inform generalizability and complement the ongoing practice-level evaluation of the OCM. METHODS: In this cross-sectional study, we identified characteristics of US medical oncologists practicing in 2016, using a national telephone-verified physician database. We linked these data with Dartmouth Atlas and Medicare claims data from 2011 through 2016 to identify characteristics of markets with high OCM participation. We used logistic regression to examine relationships between market characteristics and OCM participation. RESULTS: Of 10,428 US medical oncologists, 2,605 (24.9%) were listed in an OCM practice. There were no differences in sex or medical training between OCM participants and nonparticipants, although OCM participants were slightly younger. OCM participants practiced in larger (median daily patient volume, 80 v 55 patients) and urban practices (95.2% v 90.7%) and were less likely to be part of a health system (41.0% v 60.4%) or solo practice (45.5% v 67.4%; all P < .001). Participation was higher in southern and mid-Atlantic markets. Markets with high OCM physician participation had higher specialist density, hospital care intensity, and acute care use at the end of life (all P < .001). Market-level penetration of Accountable Care Organizations (adjusted odds ratio, 4.65; 95% CI 3.31 to 6.56; P < .001) and Medicare Advantage (adjusted odds ratio 2.82; 95% CI, 1.97 to 4.06; P < .001) were associated with higher OCM participation. CONCLUSION: In the first description of oncologists participating in the OCM, we found differences in practice demographics, care intensity, and exposure to nontraditional payment models between OCM-participating and nonparticipating physicians. Such provider-level differences may not be captured in Medicare’s practice-level analysis.

scholarly journals Exploring the Experiences of Patients in the Oncology Care Model

2020 ◽  
Vol 16 (12) ◽  
pp. e1433-e1440
Author(s):  
Elizabeth F. Franklin ◽  
Helen M. Nichols ◽  
Linda Bohannon
Keyword(s):  
Adverse Effects ◽  
Cancer Care ◽  
Survey Methodology ◽  
Cross Sectional Study ◽  
Care Team ◽  
Care Model ◽  
Social Emotional ◽  
Cross Sectional ◽  
Cancer Support ◽  
Oncology Care

PURPOSE: The Oncology Care Model (OCM) was developed to improve care while also supporting patient-centered practices. This model could significantly affect experiences of patients with cancer; however, previous studies have not explored patient perspectives. PATIENTS AND METHODS: This cross-sectional study used focus group and survey methodology to explore patient experiences in the OCM. The sample included 213 patients (OCM patients, n = 130 recruited within OCM practices; non-OCM patients, n = 83 recruited via e-mail from the Cancer Support Community Cancer Experience Registry). RESULTS: Findings suggest that patients in OCM practices were more likely to report that their cancer care team asked about social/emotional distress or concerns and more likely to have social/emotional resources offered. OCM patients were also more likely to have discussed advance directives with providers. They were also more likely to be satisfied with provider explanations of treatment benefits as well as treatment risks and adverse effects. Lastly, OCM patients were significantly more satisfied with discussion of treatment costs and provided higher ratings of preparation by their cancer care team for management of adverse effects. CONCLUSION: Patients in this study reported experiences consistent with many of the key goals of the OCM. This is promising and may indicate the need to expand the model. However, because of the potential selection bias of our sampling method, more research is needed.

scholarly journals Health Care Utilization and Symptom Severity in Ghanaian Children – a Cross-Sectional Study

PLoS ONE ◽  
2013 ◽  
Vol 8 (11) ◽  
pp. e80598 ◽  
Author(s):  
Ralf Krumkamp ◽  
Nimako Sarpong ◽  
Benno Kreuels ◽  
Lutz Ehlkes ◽  
Wibke Loag ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Utilization ◽  
Symptom Severity ◽  
Cross Sectional Study ◽  
Care Utilization ◽  
Sectional Study ◽  
Cross Sectional

scholarly journals Antenatal care among women in Chitwan district of Nepal: A cross-sectional study

2021 ◽  
Vol 9 (01) ◽  
pp. 74-86
Author(s):  
Sharmila Pokharel ◽  
Ram Krishna Maharjan
Keyword(s):  
Antenatal Care ◽  
Educational Level ◽  
Health Workers ◽  
Cross Sectional Study ◽  
Reproductive Age ◽  
Care Utilization ◽  
Sectional Study ◽  
Related Factors ◽  
Cross Sectional ◽  
Care Community

Antenatal care is one of the most effective measures to reduce maternal mortality in Lower Middle-income Countries. The study aims to assess the utilization of antenatal care and related factors by breastfeeding mothers in Chitwan district of Nepal. A cross-sectional study was carried out in Bharatpur municipality in April 2020, among all women of the reproductive age group (15-49) who have had a birth child in the last 12 months before the survey date. A census sampling technique was used to select respondents. The vaccination period was two weeks. All the mothers who came to the vaccine center to vaccinate their children were the respondents of this study. The data were collected by using an interview schedule. The collected data were managed using SPSS Version 20. The study found that 84.31 percent of respondents attended more than four antenatal care utilization. The educational level of the respondents and the occupation of their partners were linked to the use of antenatal care. The number of pregnancies, the number of live births, the place of delivery, and the educational level and occupations of the birth attendees were also significantly linked to the use of antenatal care. Community mobilization and intensive use of community health workers are essential factors to improve the use of antenatal care.

scholarly journals Assessment of the factors influencing primary care physicians’ approach to vaccination of adult risk groups in Istanbul, Turkey

PeerJ ◽  
2019 ◽  
Vol 7 ◽  
pp. e7516
Author(s):  
Fatma Yılmaz Karadağ ◽  
Zuhal Aydan Sağlam
Keyword(s):  
Primary Care ◽  
Primary Care Physicians ◽  
Medical Training ◽  
Risk Group ◽  
Risk Groups ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Factors Influencing ◽  
Demographical Data ◽  
Adult Immunization

Background We aimed to assess the factors influencing primary care physicians’ (PCPs) approach to adult vaccination in specific risk groups and evaluate the compliance to adult immunization guidelines. Methods This cross-sectional study performed between January 2016 and April 2016 in İstanbul, Turkey. A questionnaire designed to obtain physicians’ demographical data, experience, immunization status, and attitude on prescribing or recommending vaccines for adults in the risk group. Healthy individuals older than 65 and patients suffer from chronic diseases or had splenectomy before are considered as a risk group. The questionnaire was sent via email to a randomly selected group of 1,500 PCPs. The data of 221 physicians who responded emails were recorded for statistical analysis. Results Of the 221 participants (123 women, 98 men), the majority were aged 31–40 years. Their vaccination rates were 74.2% for hepatitis B, 54.3% for seasonal influenza, and 47.1% for tetanus. Among participants, the highest recommendation and prescription rate of adult vaccines was recorded in PCPs aged 31–40 years. In addition, PCPs with <10 years occupational experience were found to prescribe adult vaccines more frequently than PCPs with longer occupational experience. Conclusions Primary care physicians with lower age and relatively less experience are more intent to prescribe adult vaccines to patients that are in risk groups. This result may be due to increased awareness of adult immunization among PCPs who had more recent medical training. However, many other factors could have caused this difference, including physicians’ approach to primary medical care.

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