2019 ASCO Annual Meeting!
Session: Health Services Research, Clinical Informatics, and Quality of Care
Type: Poster Session
Time: Saturday June 1, 1:15 PM to 4:15 PM
Location: Hall A
Impact of Oncology Care Model (OCM) reporting requirements on quality of care.
Quality of Care/Quality Improvement
Health Services Research, Clinical Informatics, and Quality of Care
2019 ASCO Annual Meeting
Poster Board Number:
Poster Session (Board #311)
J Clin Oncol 37, 2019 (suppl; abstr 6620)
Author(s): Emily Castellanos, Abigail Orlando, James Hamrick, Xinran Ma, Gillian O'Connell, Neal J. Meropol, Blythe J.S. Adamson; Flatiron Health, New York, NY; Flatiron Health, New York, NY and Case Comprehensive Cancer Center, Cleveland, OH
Background: The OCM is a voluntary Center for Medicare and Medicaid Innovation alternative payment model pilot program. As of Oct 2017, OCM practices are required to report the biomarker status for NSCLC pts. Our objective was to assess the effect of OCM reporting on quality of care in aNSCLC. Methods: We developed a decision-analytic model to compare the likelihood of receiving biomarker testing and corresponding appropriate therapy. We populated the model using real-world data from pts (n=7,075) at OCM sites (n=45) and non-OCM sites (n=105) in the Flatiron Health electronic health record (EHR)-derived database. The pre-period control included pts diagnosed with aNSCLC from Jan 1, 2011 - Dec 31, 2015; the post-period included pts diagnosed Oct 2017 - Nov 2018. For OCM vs non-OCM sites, we estimated probabilities and unadjusted odds ratio (OR) of biomarker testing (EGFR, ROS1, or ALK) and subsequent delivery of appropriate therapy, defined as use of a biomarker-guided tyrosine kinase inhibitor (TKI) for positive pts, or non-TKI therapy for negative pts. Results: No differences in rates of biomarker testing or delivery of appropriate therapy were detected between OCM and non-OCM practices prior to the reporting requirement. In the post-period, OCM was associated with higher odds of biomarker testing and appropriate therapy (Table). Conclusions: To our knowledge, this is the first study of the association of OCM reporting requirements with downstream quality of care. Our results suggest that OCM documentation and reporting requirements are associated with modestly higher quality of care for pts with aNSCLC. Ongoing sensitivity analyses will determine the relative contribution of provider and practice characteristics to these findings. Careful measurement of the impact of reporting requirements is essential to measure the impact of payment reform interventions and inform policy.
|Outcomes||Non-OCM (%)||OCM (%)||OR||p-value|
|Biomarker testing rate||81.3||85.2||1.32||0.036|
|Overall Total: testing and appropriate therapy delivered||72.1||76.4||1.25||0.042|
|Appropriate first-line therapy (TKI) among biomarker positive||63.6||68.5|
|Appropriate first-line therapy (non-TKI) among biomarker negative||98.3||98.3|