Patient engagement on claims-registry reports of cost and quality.

Authors

null

Karma L. Kreizenbeck

Hutchinson Institute for Cancer Outcomes Research, Fred Hutchinson Cancer Research Center, Seattle, WA

Karma L. Kreizenbeck, Catherine R. Fedorenko, Julia Rose Walker, Mikael Anne Greenwood-Hickman, Laura Panattoni, Sarah Barger, Keith D. Eaton, Janet Freeman-Daily, Diane Mapes, Margaret Leigh Pate, Courtney J. Preusse, Gary H. Lyman, Scott David Ramsey

Organizations

Hutchinson Institute for Cancer Outcomes Research, Fred Hutchinson Cancer Research Center, Seattle, WA, Fred Hutchinson Cancer Research Center, Seattle, WA, University of Washington, Seattle, WA, GrayConnections.net, Federal Way, WA, Patient Advocate, Fred Hutchinson Cancer Research Center, Seattle, WA

Research Funding

Other

Background: Moving cancer care towards a value framework requires patients, providers, and payers to weigh cost, quality, and outcomes in decision-making. Many efforts are underway to help providers and payers make value decisions, but little has been developed for patients. Our regional value in cancer care effort used a claims-registry database to develop quality and cost reports aiming to provide actionable data to all stakeholders. Methods: Reports were generated using cancer registry records for Western WA from 2007-2015 linked with claims from two regional commercial insurers. Patients were presented quality reports on regionally prioritized metrics and the 2012 ASCO Choosing Wisely guidelines on breast cancer surveillance and EOL care. Patients also reviewed cost reports for episodes of care (diagnosis, treatment, end-of-life (EOL)) and out-of-pocket (OOP) cost estimates. Feedback stemmed from 1) stakeholder meetings over a 2-year period, 2) working groups of patients, payers and providers, and 3) an annual regional meeting on value in cancer care. Results: In total, 13 patients provided feedback at one or more outreach event. See table. Conclusions: Reports from a claims-registry database may not support the information needs of patients for care decision-making or representing “value”. Patients desired understanding more about patients “like them” for decision-making.

Patient feedback on quality and cost metrics.

Quality
Cost
Breast SurveillanceEoLEpisode of CareOOP Estimate
Patient FeedbackUtilization may reflect poor
care coordination post-active
treatment; patient anxiety;
& a questioning of underlying
evidence for
recommendations
Distinguish between palliative
radiation & chemotherapy
Ongoing costs of care
(survivorship or post-active
treatment) are relevant
Cost at the health-level
does not adequately
capture total financial
burden
Guidelines do not account for
patient preferences
Concept of EOL is less important
than understanding of overall
Goals of Care
Episodes of care/insurance plan
years may not be useful construct
for patients; individual patient
yearly deductibles/copays more
accurately capture patient cost
Need for more detailed
data (i.e. in/out of network
costs; targeted therapy vs.
chemotherapy)

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Abstract Details

Meeting

2017 ASCO Quality Care Symposium

Session Type

Poster Session

Session Title

Poster Session B: Patient Safety and Science of Quality

Track

Patient Safety,Science of Quality

Sub Track

Communication, Decision Making, and Behavior

Citation

J Clin Oncol 35, 2017 (suppl 8S; abstract 159)

DOI

10.1200/JCO.2017.35.8_suppl.159

Abstract #

159

Poster Bd #

B14

Abstract Disclosures

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