Cancer Episode Payment Model for Cancer Care

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: University of Pennsylvania

Disqualifiers: Non-Hawaii Oncology providers

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: Unknown

Duration: 6 months

7 Participants Needed

Trial Summary

What is the purpose of this trial?

The HMSA Cancer Episode Payment Model (CEM) is a payment model designed to test the effects of better care coordination on health outcomes and costs of care for Hawaii Medical Services Association (HMSA) members with cancer who receive chemotherapy.

Do I need to stop my current medications for this trial?

The trial information does not specify whether you need to stop taking your current medications.

What data supports the effectiveness of the Cancer Episode Payment Model (CEM) treatment for cancer care?

The Cancer Episode Payment Model (CEM) is similar to the Oncology Care Model (OCM), which has shown success in providing high-quality, coordinated cancer care while reducing costs. The OCM has been effective in improving the use of supportive care medications and enhancing patient care by focusing on value rather than the volume of services. ^{1 2 3 4 5}

How does the Cancer Episode Payment Model treatment differ from other cancer treatments?

The Cancer Episode Payment Model is unique because it focuses on a payment system that encourages coordinated, high-quality care at a lower cost, rather than a specific medical treatment. It combines all payments for services during a cancer treatment episode into a single benchmark price, promoting efficiency and cost-effectiveness in cancer care. ^{1 2 3 6 7}

Eligibility Criteria

This trial is for oncologists in Hawaii who are part of the Hawaii Oncology network and treat HMSA members with lung, colorectal, breast, or colon cancer using chemotherapy. It's not open to providers outside this group.

Inclusion Criteria

Any oncologist who practices with Hawaii Oncology and is a participating provider.

Exclusion Criteria

Any provider who does not practice with Hawaii Oncology.

Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants receive care under the Cancer Episode Payment Model for 6 months

6 months

Follow-up

Participants are monitored for quality of care and survival outcomes

6 months

Treatment Details

Interventions

• Cancer Episode Payment Model (CEM)

Trial Overview The trial is testing a new payment model called Cancer Episode Payment Model (CEM) that aims to improve care coordination for cancer patients undergoing chemotherapy and see if it can reduce healthcare costs while improving outcomes.

Participant Groups

Group I: Cancer Episode Payment Model Experimental Treatment 1 Intervention

Oncologists in this arm will be paid for each member's episode of care. The episode of care is 6 months in duration. Oncologists will have the opportunity to receive performance-based payments based upon a set of 6 quality metrics.

Group II: Fee for Service Active Control 1 Intervention

Oncologists in this arm will not receive the intervention and will continue to be paid through fee-for-service.

Who Is Running the Clinical Trial?

University of Pennsylvania

Lead Sponsor

Trials

2,118

Recruited

45,270,000+

Hawaii Medical Service Association

Collaborator

Trials

4

Recruited

240+

References

1. United States pubmed.ncbi.nlm.nih.gov

Secret Sauce-How Diverse Practices Succeed in Centers for Medicare & Medicaid Services Oncology Care Model. [2022]

2. United States pubmed.ncbi.nlm.nih.gov

Design Challenges of an Episode-Based Payment Model in Oncology: The Centers for Medicare & Medicaid Services Oncology Care Model. [2019]

3. United States pubmed.ncbi.nlm.nih.gov

Impact of the Oncology Care Model on Use of Supportive Care Medications During Cancer Treatment. [2022]

4. United States pubmed.ncbi.nlm.nih.gov

Modeling Episode-Based Payments for Cancer Using Commercial Claims Data. [2023]

5. United States pubmed.ncbi.nlm.nih.gov

Lessons from an oncology medical home collaborative. [2019]

6. France pubmed.ncbi.nlm.nih.gov

[Episode-based bundled payment model: evaluation of medical costs for early operable breast cancer]. [2021]

7. United States pubmed.ncbi.nlm.nih.gov

Specialty Payment Model Opportunities and Assessment: Oncology Model Design Report. [2022]