A community oncology palliative care program: Pain-related inpatient utilization in oncology care model (OCM) patients.

Authors

null

Adil Jamal Akhtar

Michigan Health Professionals, Sterling Heights, MI

Adil Jamal Akhtar , Jeffrey H. Margolis , Karna Sheth , Andrew A. Muskovitz , Karma Maxwell , Richard Philip Zekman , George Howard , Yusuf Qamruzzaman , Savitha Balaraman , Samer Ballouz , Mohammed Ibrahim , Mitchell Folbe , Mohammed S. Ogaily , Lexi Stortz , Maria Fabbiano , Shehnaz Pancholi , Anoosha Maria Tauquir

Organizations

Michigan Health Professionals, Sterling Heights, MI, Michigan Health Professionals, Farmington Hills, MI, Everett Castle LLC, Chicago, IL, Michigan Health Professionals/Premiere Hospice, Sterling Heights, MI, Michigan Health Professionals, Royal Oak, MI, Cancer and Leukemia Ctr, Sterling Heights, MI, Michigan Health professionals, Royal Oak, MI, Oakland Medcl Grp, Madison Heights, MI, Michigan Health Professionals, Troy, MI, MHP, Sterling Heights, MI, Michigan Health Professionals, Brownstown, MI, Integra Connect, West Palm Beach, FL, Premier Hospice, Troy, MI

Research Funding

No funding received
None

Background: Oncology Division of Michigan Health Professionals (MHP) participates in OCM. A comprehensive community oncology program for early and timely involvement of palliative care (PC) was launched in September 2017 to help achieve the OCM program goals of high-quality, cost-effective, coordinated care. PC provides a single point of care for all-cause pain management. PC program included pre-program training and continuous education for early and timely involvement of PC. This study aims to assess the educative effect of PC to reduce pain-related inpatient admissions (Pain IP) in all MHP OCM patients, irrespective of PC-referral. Methods: This initiative was led by palliative care physicians and included continuous education and reinforcement of the benefits, every 2-4 weeks, by sharing PC outcomes data with MHP physicians. Physician feedback was part of the program enhancements that were regularly reviewed during monthly MHP physician meetings. Retrospective claims review was performed with OCM episodes from Oct 2016 – Mar 2019. Monthly Pain IP utilization (based on diagnosis code) per 1000 OCM patients (UPK) was analyzed within pre- and post- PC Program start (Sep 2017). Cost per Pain IP included mean of 30-day follow-up skilled nursing facility (SNF) stay and 30-day outpatient facility expenses. Monthly historical Pain IP (pre-PC UPK) was compared to post-PC Pain IP UPK to calculate OCM savings from PC education at MHP. Results: Pain IP peaked at 7.12 UPK in September 2017 when PC program training and education started, then fell as low as 0.87 UPK in January 2019. Unit cost per Pain IP was $12,473. Post-PC (Sep 2017 – Mar 2019), there were 40 fewer Pain IP admissions compared to Pre-PC Pain IP for a total cost savings of $498,920. Conclusions: After PC Program, Pain IP decreased in MHP OCM population (PC-referred and PC not referred). This trend suggests PC training and continuous education for OCM providers is reducing IP utilization. This also translated to a significant cost saving for OCM/Medicare of $498,920. Study was limited by OCM claims available as of December 2019. Results may be refreshed as more data becomes available.

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Abstract Details

Meeting

2020 ASCO Virtual Scientific Program

Session Type

Poster Session

Session Title

Symptoms and Survivorship

Track

Symptom Science and Palliative Care

Sub Track

Palliative Care and Symptom Management

Citation

J Clin Oncol 38: 2020 (suppl; abstr 12094)

DOI

10.1200/JCO.2020.38.15_suppl.12094

Abstract #

12094

Poster Bd #

382

Abstract Disclosures

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