• Am J Manag Care · Dec 2019

    Outcome measures for oncology alternative payment models: practical considerations and recommendations.

    • Jakub P Hlávka, Pei-Jung Lin, and Peter J Neumann.
    • Tufts Medical Center, 800 Washington St, Box 63, Boston, MA 02111. Email: PLin@tuftsmedicalcenter.org.
    • Am J Manag Care. 2019 Dec 1; 25 (12): e403e409e403-e409.

    ObjectivesThis paper aims to synthesize existing scholarship on quality measures in oncology, with a specific focus on outcome-based quality measures, which are often underutilized. We also present a set of "core outcome measures" that may be considered in future oncology alternative payment models (APMs).Study DesignOur research consists of a focused literature review, content analysis, and quality measure synthesis and categorization.MethodsWe conducted a focused literature review to generate key evidence on quality measures in oncology. We studied 7 oncology quality assessment frameworks, encompassing 142 quality metrics, and synthesized recommendations using the Center for Medicare and Medicaid Innovation APM toolkit, focusing on outcome measures.ResultsWe present 34 outcome-based oncology quality measures for consideration, which are classified into 5 domains: clinical care (eg, hospital and emergency department visits, treatment effectiveness, mortality), safety (eg, infections, hospital adverse events), care coordination (for hospital and hospice care), patient and caregiver experience, and population health and prevention. Both general and indication-specific outcome measures should be considered in oncology APMs, as appropriate. Utilizing outcome-based measures will require addressing multiple challenges, ranging from risk adjustment to data quality assurance.ConclusionsOncology care will benefit from a more rigorous approach to quality assessment. The success of oncology APMs will require a robust set of quality measures that are relevant to patients, providers, and payers.

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