Oncology Episode Payment Model in Hawaii

Study Overview
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Brief Summary
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The HMSA Cancer Episode Payment Model (CEM) is a payment model designed to test the effects of better care coordination on health outcomes and costs of care for Hawaii Medical Services Association (HMSA) members with cancer who receive chemotherapy.

Detailed Description
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The CEM is designed to improve community health, to improve care coordination, quality, and appropriateness of care, to improve patient experience, and to implement a value-based incentive structure that appropriately rewards oncologists for cost-savings and sustained of improved quality of care.

Official Title
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Oncology Episode Payment Model in Hawaii

Conditions
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Breast Cancer, Colon Cancer, Lung Cancer

Intervention / Treatment
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* Other: Cancer Episode Payment Model (CEM)


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Any oncologist who practices with Hawaii Oncology and is a participating provider. Exclusion Criteria: Any provider who does not practice with Hawaii Oncology.

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Health Services Research
Allocation: Non-Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Cancer Episode Payment Model<br>Oncologists in this arm will be paid for each member's episode of care. The episode of care is 6 months in duration. Oncologists will have the opportunity to receive performance-based payments based upon a set of 6 quality metrics. | Other: Cancer Episode Payment Model (CEM)<br>* Oncologists will be paid for an episode of care with the opportunity to receive a value based payment based on 6 quality metrics.<br>|
| No Intervention: Fee for Service<br>Oncologists in this arm will not receive the intervention and will continue to be paid through fee-for-service. | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Composite quality score | Quality metrics included in the oncology model will be compared across the two arms. | 1 year | 
| Episode cost | Total spending of oncology patients in the episode will be compared across the two arms. | 6 months | 
| Utilization of acute and specialty care | Total utilization of acute and specialty care of oncology patients in the episode will be compared across the two arms | 6 months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Quality of care at end of life | Quality measures evaluating use of acute care and palliative care services at the end of life will be compared across the two arms | 6 months | 
| Survival | All cause mortality will be compared across the two arms | one year |