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A study, Enhancing community capacity to deliver value-based cancer care at the end-of-life

Enhancing community capacity to deliver value-based cancer care at the end of life rThe study enrolled CareMore patients newly diagnosed with solid and hematologic malignancies from November 2016 through September 2018, and compared outcomes to a control group of all patients diagnosed with cancer in the year prior to intervention. The value-based cancer care model utilized LHWs, which are non-physician members of the community who have received specialized training to support the patient care and navigation. The study found there was no difference in survival between the groups, while the patients receiving the value-based care experienced better quality with end-of-life cancer care. The latter group had 40 percent lower inpatient admissions, 75 percent fewer emergency department visits in the last month of life, 45 percent increased hospice use, 40 percent fewer acute care facility deaths and 25 percent lower median total healthcare costs from diagnosis until death. “Through this study, the value-based care model developed by our group at Stanford and implemented by The Oncology Institute is associated with significant improvements in care for patients at the end of life,” said the study’s lead investigator, Manali Patel, MD, MPH, assistant professor of medicine at the Stanford University School of Medicine. “As providers, it’s important to support patient care with innovations that address patient’s needs and can improve patient experiences, while also lowering the total cost of care.” For all patients who died within 12 months, their risk of death was analyzed using Cox Models and generalized linear regression to compare healthcare use in the last month of life, and total costs of care from diagnosis until death. All models were adjusted for age, stage, comorbidities, diagnosis and length of follow-up.

“We are excited to collaborate with Stanford and with The Oncology Institute on this important study to implement impactful care redesign to improve the care and experience for this group of patients,” said Dr. Anil Hanuman, regional chief medical officer of CareMore Health.

“CareMore specializes in treating high-risk patients requiring complex, acute and chronic care—including those battling cancer—and recognizes the impact this innovative model of care could potentially have on patients, their care – and on healthcare costs.”

“This study is another proof point that the patient-centric and comprehensive care model developed at Stanford and implemented by The Oncology Institute and CareMore Health is the direction that the medical oncology model should be going,” said Richy Agajanian, MD, chief medical officer and senior regional director at TOI.

“We are excited to provide this model of care to patients nationally as we continue to expand our partnerships with health care systems such as CareMore that are seeking to improve patient care and lower financial burden on patients through value-based oncology care”.

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