Cancer Care Quality Program Shows Promising Results in Improving Patient Outcomes

A new cancer quality initiative and payment model, the Cancer Care Quality Program, is demonstrating positive outcomes in improving cancer care and reducing costs. Developed by Anthem, Inc., the program aims to promote evidence-based and cost-effective care for patients with cancer. As of June 1, the program is being implemented in 13 states, and preliminary results show that oncologists are embracing the program and its treatment pathways. With over 78% of participating oncology practices having at least one patient registered, the program is on track to achieve its goal of providing high-quality care to more patients.

Key Takeaways:

• Approximately two-thirds of patients with colon, breast, and non-small cell lung cancer were registered with the Cancer Care Quality Program, based on chemotherapy claims data.
• Over 78% of oncology practices had at least one patient registered with the program, demonstrating a high level of participation and engagement.
• 72% of registered patients with colon cancer were being treated with a therapy designated on pathway and recommended by Anthem as the most likely to produce the best outcomes and reduce side effects.
• 63% of registered patients with breast cancer and 63% of those with non-small cell lung cancer were receiving care aligned with the designated treatment pathways.
• Anthem anticipates that about 85% of all chemotherapy requests for registered patients will be on pathway when the program is fully mature.
• The program is expanding to include other cancers, such as ovarian, pancreatic, leukemia, lymphoma, melanoma, myeloma, prostate, and central nervous system cancers.
• Oncology practices provide clinical data on biomarkers, performance status, and planned treatment into the Cancer Care Quality Program platform, administered and developed in collaboration with AIM Specialty Health.
• Participating oncologists who choose a designated treatment pathway are eligible to receive an additional $350 payment for treatment planning and care coordination for each month the patient is in active therapy.
• Rates of participation and pathway adherence were estimated based on clinical and claims data.

Statistics:

• 66% of patients with colon, breast, and non-small cell lung cancer were registered with the Cancer Care Quality Program (based on chemotherapy claims data).
• Over 78% of oncology practices had at least one patient registered with the program.
• 72% of registered patients with colon cancer were being treated with a therapy designated on pathway.
• 63% of registered patients with breast cancer were receiving care aligned with the designated treatment pathways.
• 63% of registered patients with non-small cell lung cancer were receiving care aligned with the designated treatment pathways.
• 85% of all chemotherapy requests for registered patients are anticipated to be on pathway when the program is fully mature.
• 13 states are currently participating in the program, with plans to expand to additional states.

Sources:

• Anthem, Inc.
• American Society of Clinical Oncology Annual Meeting
• AIM Specialty Health
• HealthCore, an outcomes research subsidiary
• Contify.com (Copyright 2014)