Spending Among Patients With Cancer in the First 2 Years of Accountable Care Organization Participation

Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology
Miranda B LamAshish K Jha

Abstract

Spending on patients with cancer can be substantial and has continued to increase in recent years. Accountable Care Organizations (ACOs) are arguably the most important national experiment to control health care spending, yet how ACOs are managing patients with cancer diagnoses is largely unknown. We aimed to determine whether practices that became ACOs had changes in overall or cancer-specific spending among patients with cancer. Using 2011 to 2015 national Medicare claims, practices that became part of ACOs were identified and matched to non-ACO practices within the same geographic region. We calculated total and category-specific annual spending per beneficiary as well as spending for and utilization of emergency departments, inpatient admissions, hospice, chemotherapy, and radiation therapy. A difference-in-differences model was used to examine changes in spending and utilization associated with ACO contracts in the Medicare Shared Savings Program for beneficiaries with cancer. We found that the introduction of ACOs had no meaningful impact on overall spending in patients with cancer (-$308 per beneficiary in ACOs v -$319 in non-ACOs; difference, $11; 95% CI, -$275 to $297; P = .94). We found no changes in total spending in...Continue Reading

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Citations

Apr 11, 2019·Journal of the American Geriatrics Society·Hyosin KimChristine E Bishop
Aug 9, 2019·Journal of Oncology Practice·Ravi B ParikhAmol S Navathe
Apr 10, 2019·Journal of Hospice and Palliative Nursing : JHPN : the Official Journal of the Hospice and Palliative Nurses Association·Serena Wu, Deborah L Volker
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Dec 6, 2019·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Aaron A LavianaMatthew J Resnick
Jun 12, 2020·Cancer Epidemiology, Biomarkers & Prevention : a Publication of the American Association for Cancer Research, Cosponsored by the American Society of Preventive Oncology·Angela B MariottoK Robin Yabroff
Nov 10, 2021·JAMA : the Journal of the American Medical Association·Nancy L KeatingUNKNOWN Oncology Care Model Evaluation Team
Nov 13, 2021·Cancer·Daniel E Lage, Katrina A Armstrong

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