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| Name | Class |
|---|---|
| Hawaii Medical Service Association | OTHER |
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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.
The CEM is designed to improve community health, to improve care coordination, quality, and appropriateness of care, to improve patient experience, and to implement a value-based incentive structure that appropriately rewards oncologists for cost-savings and sustained of improved quality of care.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Cancer Episode Payment Model | Experimental | 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. |
|
| Fee for Service | No Intervention | Oncologists in this arm will not receive the intervention and will continue to be paid through fee-for-service. |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Cancer Episode Payment Model (CEM) | Other | Oncologists will be paid for an episode of care with the opportunity to receive a value based payment based on 6 quality metrics. |
|
| Measure | Description | Time Frame |
|---|---|---|
| Composite quality score | Quality metrics included in the oncology model will be compared across the two arms. | 1 year |
| Episode cost | Total spending of oncology patients in the episode will be compared across the two arms. | 6 months |
| Utilization of acute and specialty care | Total utilization of acute and specialty care of oncology patients in the episode will be compared across the two arms | 6 months |
| Measure | Description | Time Frame |
|---|---|---|
| Quality of care at end of life | Quality measures evaluating use of acute care and palliative care services at the end of life will be compared across the two arms | 6 months |
| Survival | All cause mortality will be compared across the two arms |
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Inclusion Criteria:
Exclusion Criteria:
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Hawaii Oncology | Honolulu | Hawaii | 96701 | United States |
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| ID | Term |
|---|---|
| D001943 | Breast Neoplasms |
| D003110 | Colonic Neoplasms |
| D008175 | Lung Neoplasms |
| ID | Term |
|---|---|
| D009371 | Neoplasms by Site |
| D009369 | Neoplasms |
| D001941 | Breast Diseases |
| D012871 | Skin Diseases |
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| one year |
| D017437 |
| Skin and Connective Tissue Diseases |
| D015179 | Colorectal Neoplasms |
| D007414 | Intestinal Neoplasms |
| D005770 | Gastrointestinal Neoplasms |
| D004067 | Digestive System Neoplasms |
| D004066 | Digestive System Diseases |
| D005767 | Gastrointestinal Diseases |
| D003108 | Colonic Diseases |
| D007410 | Intestinal Diseases |
| D012142 | Respiratory Tract Neoplasms |
| D013899 | Thoracic Neoplasms |
| D008171 | Lung Diseases |
| D012140 | Respiratory Tract Diseases |