BASELINE CHARACTERISTICS OF PATIENTS PROVIDED CANCER CARE WITHIN A NOVEL COMMERCIAL HEALTH PLAN CANCER CARE QUALITY PROGRAM

Author(s)

Willey V1, Quimbo R1, Tunceli O1, Mack M1, Malin J2
1HealthCore Inc., Wilmington, DE, USA, 2Anthem, Woodland Hills, CA, USA

OBJECTIVES: The Cancer Care Quality Program (CCQP), a novel program by Anthem Inc. health plans designed to align reimbursement with evidence-based, cost-effective oncology treatment, collects clinical data that can be integrated with the administrative claims data in the HealthCore Integrated Research Database (HIRD).  This study evaluated baseline characteristics of patients within oncology practices participating in the CCQP. METHODS: Breast, colon, and lung cancer patients from practice sites participating in the CCQP were identified between 6/23/2014 and 12/3/2014 (Intake Period). Patients were characterized based on the earliest request to utilize chemotherapy and/or supportive care medications (Index Date) during the Intake Period; analyses included patients with ≥6 months of continuous pre-index eligibility. CCQP clinical data was integrated with HIRD administrative claims data. Baseline characteristics were stratified by cancer type/stage and included: pathology, biomarkers, ECOG performance status, and Deyo-Charlson Index (DCI). RESULTS: A total of 1,230 breast, 329 colon, and 554 lung cancer patients were identified with mean(SD) ages and DCI’s of  55(11), 58(10), and 62(9) and 5.7(3.2), 7.6(2.6), and 7.7(2.8), respectively. Stage distributions indicated the greatest prevalence with stage IV disease: 39%, 73%, and 68% among breast, colon, and lung cancers patients. Pathology results among lung cancer patients demonstrated 78% and 22% with non-small cell and small cell cancers, respectively.  36% of breast cancer patients were HER2 positive, 29% of lung cancer patients were detected with EGFR mutation, and 39% of colon cancer patients were detected with KRAS mutation among those reporting test results. The majority of patients in each cancer group (81.7%-90.3%) had an ECOG performance status of 0 or 1. CONCLUSIONS: Given the recent implementation of the CCQP, this analysis provides valuable initial insight into the demographic and clinical characteristics of patients within participating practices.  This integrated data provides a comprehensive picture for commercially-insured oncology patients and baseline data for future program evaluation.

Conference/Value in Health Info

2015-05, ISPOR 2015, Philadelphia, PA, USA

Value in Health, Vol. 18, No. 3 (May 2015)

Code

PCN153

Topic

Health Service Delivery & Process of Care, Real World Data & Information Systems

Topic Subcategory

Health & Insurance Records Systems, Hospital and Clinical Practices, Prescribing Behavior, Treatment Patterns and Guidelines

Disease

Oncology

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