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Defining Accountable Cancer Care

DEFINING ACCOUNTABLE CANCER CARE Unclear Return on Today's Cancer Care Investment Rising Costs Exacerbate Concerns about "Value" Seeing Results..but Not Due to Spending Cancer Services Growing Significantly Projected Oncology Spending and Growth Rate* -$207 B FORECAST TWO: COST INCREASE Forecast assumes a 5% increase in costs in the initial and last-year phases of treatment SPENDING Cancer Death Rates' 1990-2007 Cost and Outcomes for Breast Cancer Patients? Oncology Inpatient Discharges Outpatient Oncology Services $125 B 66% TEN YEAR GROWTH RATE Spending and Outcomes Not Correlated 2010 2015 2020 2010 2015 2020 SPENDING ON CANCER SERVICES MEN WOMEN 100% LOWEST COST QUINTILE 75% $27,233 $155 B FORECAST ONE: BASE CASE and coste 17% $24,574 50% $22217 1.164.024 1.189.915 1.226.541 1.666.235 1880,620 2.311,063 $19.719 SPENDING st holds incidence, survival ts steady 25% $17,319 24% TEN YEAR GROWTH RATE N1380 N1022 898,000 -5% -38%* PERCENTAGE ALIVE AT FIVE YEARS CANCER DEATHS AVOIDED + MEDIAN EXPENDITURE PER PATIENT GROWTH GROWTH 2010 2020 Six Imperatives for Driving Value in Cancer Care Ensure Adherence to Evidence-Based Guidelines Reduce Unnecessary IP and ED Utilization Engage Patients and Families in End-of-Life Planning Leverage Networks to Advance Cost, Quality Goals Focus Service Investments Enhance Patient-Provider Communication on Services that Increase Quality Non-Evidence-Based Care Rampant Breast Biopsies Variation Indicates Improvement Need Statistics per 1,000 Cancer Patients Many Possible Services to Invest in. but Resources are Limited Strategies for Coordination of Care Across the Health System Percentage of Institutions Pursuing, 2011 Patients Struggle to Absorb Information Spending Skyrockets in Last Month of Life Mean Inpatient and Total Cost in the Months Before Death Colon Cancer <50% 2,000 13% 1,626 Oncology Leaders' Service Importance Scores INFORMATION THAT CANCER PATIENTS RETAIN FOLLOWING THEIR FIRST CONSULT $7,834 $25,261- MEAN TOTAL COST SINGLE BUDGET 23% 12% 35% FOR ALL SYSTEM CANCER FACILITIES UNNECESSARY OF PATIENTS RECEIVE NON- EVIDENCE BASED CHEMOTHERAPY PHYSICIAN CHAMPION 84% SURGICAL BIOPSIES PER YEAR MEAN TOTAL COST 65% $1,785 $20,559 MEAN 929 TUMOR BOARD MEAN INPATIENT Strategy: Treatment Plans Improve Communication, Reduce Distress Patients Receiving Treatment Plans/Summary $5,000 $14,285 484 NURSE NAVIGATOR 61% 378 ADDITIONAL COST PER PATIENT MULTIDISCIPLINARY CARE SUBSPECIA STANDARDIZED TREATMENT PATHWAYS/ PROTOCOLS ADDITIONAL COST PER PATIENT 223 61% 41% 75% 25% 57% CHEMOTHERAPY RELATED ED VISITS CHEMOTHERAPY-RELATED INPATIENT ADMITS CLINICAL QUALITY TRACKING Strategy: Increase Evidence-Based Care with Pathways Screening Treatment Plans for Efficacy. Toxicity. and Cost Yields the Optimal Choice I NATIONAL AVERAGE I HIGH UTILIZATION RATE I LOW UTILIZATION RATE 94% IMPROVED COMMUNICATION WITH DOCTORS 72% GAVE GREATER PEACE OF MIND Patient Mean Service Importance Scores 23% 74% SYSTEM LEVEL ONCOLOGY STRATEGIC PLAN 5196 MONTHS ONE MULTIDISCIPLINARY 19.7 26% CARE SYMPTOM 19.0 MANAGEMENT Strategy: Engage Patients through the Medical Home Model Strategy: Honor Patients' Wishes, Reduce Unwanted Treatments through End-of-Life Planning" Patients Reporting End-of-Life Discussions NAVIGATION 14.2 Treatment Plans CENTRALIZED GOVERNANCE COMMITTEE 54% 31% 85% Patient Empowerment Reduces Hospitalizations, ED Visits COMMUNITY OFFICES 15% Patients Not Forthcoming about Physical, Psychosocial Concerns Screen for Efficacy INFORMATION MANAGEMENT 9.8 I DID NOT HAVE AN END OF-LIFE DISCUSSION ACTIVE PATIENT ENGAGEMENT Patients empowered to be active in care management PROTOCOLS FOR COORDINATING 56% 15% 71% Contact oractice immediately when there are any problems Strategy: Improve Timeliness, Coordination, and Guideline Compliance with Multidisciplinary Carelo MEDIAN NUMBER OF SYMPTOMS VOLUNTEERED BY CANCER PATIENTS HAD AN END-OF-LIFE DISCUSSION CARE AND SHARING INFORMATION BETWEEN SITES Screen for Toxicity 10 TELEPHONE TRIAGE BEFORE Comprehensive system to manage patient symptoms AFTER MDC MEDIAN NUMBER OF SYMPTOMS REVEALED THROUGH SYSTEMATIC ASSESSMENT PROTOCOLS FOR Key driver of decreased ED utilization and inpatient admissions 10 MEAN DAYS TO STAGING COMPLETION Aggregate Costs of Care in the Last Week of Life REFERRING PATIENTS BETWEEN SITES 15% Strategy: Telephonic Symptom Managements Chemotherapy Patients Complete Daily Symptom Questionnaires. Receive Care as Needed Screen for Cost LJANT WITH STAGING CO NCCN GUIDELINES PATIENT NAVIGATORS 64% 93% Gather all clinical data 67% 20% 87% Arrange appointments with other physicians and schedule testing 61% PERCENTAGE WITH UNNECESSARY STUDIES CLINICAL QUALITY ACROSS SYSTEM 13% Optimal Choice Н $2.917 $1.876 57% REDUCTION IN UNPLANNED CHEMOTHERAPY- RELATED HOSPITALIZATIONS I IN USE I IN DEVELOPMENT I NOT PURSUING 18 MEDIAN DAYS UNTIL LAST PRETREATMENT VISIT 14 COMPREHENSIVE EMR 35% Customized to serve as disease management tool Includes standardized documentation and symptom tracking 97% MEAN PRETREATMENT PHYSICIAN APPOINTMENTS 2.9 3.6 DECREASE REDUCTION IN UNPLANNED CHEMOTHERAPY- RELATED CLINIC VISITS 2000 O un r The Advisory Board Company Oncology Roundtable octy rc etnCancer T Pattoner20-0 eted Destne we C C tea ne 0- 200 Or e O gun be ury Gubn L n LEARN MORE AT

Defining Accountable Cancer Care

shared by rmmojado on Mar 24
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Learn about the six imperatives oncology leaders should be focusing on to drive greater value in cancer care.


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