The ASTRO Perspective on “Impact of Patient Stage and Disease Characteristics on the Proposed Radiation Oncology Alternative Payment Model (RO-APM) at a Large Academic Cancer Center”

2020 ◽  
Vol 106 (5) ◽  
pp. 912-913
Author(s):  
Najeeb Mohideen ◽  
Vivek S. Kavadi ◽  
Constantine A. Mantz ◽  
Anne Hubbard
Keyword(s):  
Radiation Oncology ◽  
Cancer Center ◽  
Payment Model ◽  
Disease Characteristics

Impact of Patient Stage and Disease Characteristics on the proposed Radiation Oncology Alternative Payment Model (RO-APM)

2020 ◽  
Vol 106 (5) ◽  
pp. 905-911 ◽  
Author(s):  
Mark R. Waddle ◽  
William C. Stross ◽  
Laura A. Vallow ◽  
James M. Naessens ◽  
Launia White ◽  
...  
Keyword(s):  
Radiation Oncology ◽  
Payment Model ◽  
Disease Characteristics

Disproportionate Negative Impact of the Radiation Oncology Alternative Payment Model on Rural Providers: A Cost Identification Analysis of Medicare Claims

2021 ◽  
pp. OP.21.00330
Author(s):  
Constantine A. Mantz ◽  
Nikhil G. Thaker ◽  
Praveen Pendyala ◽  
Anne Hubbard ◽  
Thomas J. Eichler ◽  
...  
Keyword(s):  
Radiation Oncology ◽  
Negative Impact ◽  
Quality Care ◽  
Fee For Service ◽  
Current Form ◽  
Payment Model ◽  
Physician Practices ◽  
Bundled Payments ◽  
Treatment Services ◽  
Rural And Urban

PURPOSE: The Radiation Oncology Alternative Payment Model (APM) is a Medicare demonstration project that will test whether prospective bundled payments to a randomly selected group of physician practices, hospital outpatient departments, and freestanding radiation therapy centers reduce overall expenditures while preserving or enhancing the quality of care for beneficiaries. The Model follows a complicated pricing methodology that blends historical reimbursements for a defined set of services made to professional and technical providers to create a weighted payment average for each of 16 cancer types. These averages are then adjusted by various factors to determine APM payments specific to each participating provider. METHODS: This impact study segregates APM participants into rural and urban groups and analyzes the effect of the Radiation Oncology Alternative Payment Model on their fee-for-service reimbursements. RESULTS: The main findings of this study are (1) the greater net-negative revenue impact on rural facilities versus urban facilities that would have participated in the Model this year and (2) the relative lack of high-value treatment services (ie, stereotactic radiotherapy and brachytherapy) delivered by rural facilities that exacerbates their negative impact. CONCLUSION: As such, rural providers participating in the Model in its current form may face greater risk to their economic viability and greater difficulty in funding technology improvements necessary for the achievement of high-quality care compared with their urban counterparts.

Impact of the Radiation Oncology Alternative Payment Model on Brachytherapy Reimbursement

Brachytherapy ◽  
2021 ◽  
Author(s):  
Nikhil G. Thaker ◽  
Rehman Meghani ◽  
Cassandra Wilson ◽  
Jody Garey ◽  
Philip Nelson ◽  
...  
Keyword(s):  
Radiation Oncology ◽  
Payment Model

Improving the efficiency of a block schedule for treatment planning simulation in a radiation oncology department.

2014 ◽  
Vol 32 (30_suppl) ◽  
pp. 158-158
Author(s):  
Neil E. Martin ◽  
Spyros Potiris ◽  
Robert Mersereau ◽  
Mark J. Mackin ◽  
Barbara A. Jaehn ◽  
...  
Keyword(s):  
Mathematical Model ◽  
Treatment Planning ◽  
Radiation Oncology ◽  
Block Schedule ◽  
Cancer Center ◽  
Time Schedule ◽  
Patient Dissatisfaction ◽  
Schedule Flexibility ◽  
Block Time ◽  
The Mathematical Model

158 Background: The use of a weekly assigned block time schedule to allocate appointment slots to providers for treatment planning simulations caused appointment delays, provider frustration, and a perceived lack of capacity at the Dana-Farber/Brigham and Women's Cancer Center Department of Radiation Oncology. While providing predictability for physician schedules, the slots assigned to individual providers often could not accommodate their patient volume or patient availability. Consequently, providers in need of additional slots had to ‘borrow’ them from other providers. To increase schedule flexibility and reduce the need to ‘borrow’ slots, we proposed opening part of the weekly appointment slots for use by any provider. Methods: Historical data from the scheduling system were obtained to identify the weekly volume of appointment slots used by each provider within and outside their assigned time. Using these data we developed a mathematical model that allowed clinicians to convert a desired number of weekly assigned slots to slots open for use by any provider and examine the resulting effect on the number of ‘borrowed’ slots. The model illustrated the availability and usage of weekly assigned and open slots, as well as the number of ‘borrowed’ slots. Results: In the original schedule, 40% of the weekly appointment slots are ‘borrowed’. The mathematical model revealed that converting 38% of the weekly assigned slots to open slots would completely eliminate the need to ‘borrow’ slots. Conclusions: Data-driven, simple models can address complex problems in clinic operations. A mathematical model that illustrates the effect of opening slots in a block time schedule can help end-users increase efficiency in clinic, as well as eliminate provider and staff frustration, patient dissatisfaction, and delays. [Table: see text]

Choosing oncology as specialization: Medical students' perception after clinical rotation in cancer center.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. 10528-10528
Author(s):  
Omar Orlando Castillo Fernandez ◽  
Maria Lim ◽  
Lilian Hayde Montano ◽  
Gaspar Perez-Jimenez ◽  
Jhonattan Camaño ◽  
...  
Keyword(s):  
Palliative Care ◽  
Medical Students ◽  
Radiation Oncology ◽  
Cancer Care ◽  
Medical Oncology ◽  
Surgical Oncology ◽  
Cancer Center ◽  
Clinical Rotation ◽  
Chi Square ◽  
Field Methods

10528 Background: Cancer is a leading cause of death worldwide and the demand for oncologist and palliative care specialists is increasing dramatically. Two years ago, The Universidad de Panama incorporated Oncology in the curriculum in order to face the shortage of professionals involved in cancer care. Little information is available concerning young medical students desire to pursue a career in oncology.The aim of this study is to evalute medical students perception about Oncology as a specialization field. Methods: An electronic survey was sent to medical students from Universidad de Panama after finishing Oncology rotation the last 2 years. Chi square and Mann Whitney U tests were used to compare variables. Results: 145 questionnaries were responded (40%). 60% female and 40% male. Median age was 25 years old. Clinical rotation during Oncology practices were: 37% in Medical Oncology, 24% in Surgical Oncology, 21% in Radiation Oncology and 18% in Palliative Care. 20% (29) of students are highly motivated to pursue a career in Oncology. 8 in Radiation Oncology. 8 in Surgical Oncology, 8 in Medical Oncology and 5 in Palliative Care. Variable associated with a oncology preference were: male gender (p=0.007), lack of human resources (p=0.009), contact with patients and family (p=0.005), good experience with mentor (p=0.002), nature and complexity of disease (p<0.001). Potential emotional burden was negatively asssociated (p=0.004) with oncology preference. 66% of students acknowledged that clinical rotation changed positively their perception about cancer patient care and a third of students haved not rule out the possibility to choose Oncology in the near future. Conclusions: Early exposition to medical student to cancer care might help to reduce the global shortage of oncologist and palliative specialists.

An analysis of sentinel events after the implementation of a comprehensive information technology system for a new cancer center

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 17047-17047
Author(s):  
P. J. Manno ◽  
N. Vogelzang ◽  
S. Sharma ◽  
A. Pomerantz ◽  
L. Fink ◽  
...  
Keyword(s):  
Medication Errors ◽  
Radiation Oncology ◽  
Financial Management ◽  
Human Error ◽  
Medical Oncology ◽  
Safety Data ◽  
Error Rates ◽  
Cancer Center ◽  
Care Plans ◽  
Sentinel Events

17047 Background: The Nevada Cancer Institute (NVCI) is the cancer center for the state of NV conducting basic and clinical research and services in medical oncology, hematology, radiation oncology, laboratory medicine, pathology, and imaging. With the national mandate for electronic medical records (EMR), we focused on selecting a comprehensive EMR/IT system during the planning of the NVCI.. The goal was to have a seamless interface between clinical services and financial management, to maintain an extensive database of pt outcomes linked to demographics for future data mining. We hypothesized that an EMR would lead to improved safety and efficiency in patient care. Methods: Pt visits began 3/05 with paper records while EMR systems were being reviewed. Ultimately, IMPAC Medical Systems, Inc was selected. After extensive testing and re-configuration of an existing IMPAC system by the IT department and extensive training sessions, a rapid transition from paper records to a complete paperless environment occurred 9/05. As of 12/31/06, we have seen 1,271 patients. Since the care plans, lab interface and drug bar coding were in place by 4/06, we reviewed the interval of 4–12/06 for efficacy of charge capture, reduction in medication errors, the tracking of patients in ancillary services, the development of a 3 tier approval system for drug orders, and the voice recognition system for its efficiency in reducing transcription costs and turnaround time. Results: In that interval, we recorded 3617 patient visits in the medical oncology infusion center and 4766 in radiation oncology. There were 0 sentinel events. Only 2 medication errors were made which were attributed to human error but not related to the software itself. Conclusions: These safety data appear superior to comparable error rates in a paper environment.We appear to have enhanced pt safety, reduced the costs of lost revenue, increased access to the patient record and created an opportunity to analyze pt data on a longitudinal basis. We are increasing our future reporting by implementing the IMPAC Quantros Safety and Risk Management System. No significant financial relationships to disclose.

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