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The impact of provider payment reforms and associated care delivery models on cost and quality in cancer care: A systematic literature review.
Nejati, Mina; Razavi, Moaven; Harirchi, Iraj; Zendehdel, Kazem; Nejati, Parisa.
Affiliation
  • Nejati M; The Cancer Institute at Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran.
  • Razavi M; The Schneider Institutes for Health Policy at the Heller School of Brandeis University, Waltham, MA, United States of America.
  • Harirchi I; The Cancer Institute at Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran.
  • Zendehdel K; The Cancer Institute at Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran.
  • Nejati P; Rasoule-Akram Hospital, Iran University of Medical Sciences, Tehran, Iran.
PLoS One ; 14(4): e0214382, 2019.
Article in En | MEDLINE | ID: mdl-30951536
OBJECTIVES: To investigate the impact of provider payment reforms and associated care delivery models on cost and quality in cancer care. METHODS: Data sources/study setting: Review of English-language literature published in PubMed, Embase and Cochrane library (2007-2019). Study design: We performed a systematic literature review (SLR) to identify the impact of cancer care reforms. Primary endpoints were resource use, cost, quality of care, and clinical outcomes. Data collection/extraction methods: For each study, we extracted and categorized comparative data on the impact of policy reforms. Given the heterogeneity in patients, interventions and outcome measures, we did a qualitative synthesis rather than a meta-analysis. RESULTS: Of the 26 included studies, seven evaluations were in fact qualified as quasi experimental designs in retrospect. Alternative payment models were significantly associated with reduction in resource use and cost in cancer care. Across the seventeen studies reporting data on the implicit payment reforms through care coordination, the adoption of clinical pathways was found effective in reduction of unnecessary use of low value services and associated costs. The estimates of all measures in ACO models varied considerably across participating providers, and our review found a rather mixed impact on cancer care outcomes. CONCLUSION: The findings suggest promising improvement in resource utilization and cost control after transition to prospective payment models, but, further primary research is needed to apply robust measures of performance and quality to better ensure that providers are delivering high-value care to their patients, while reducing the cost of care.
Subject(s)

Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Health Personnel / Delivery of Health Care / Neoplasms Type of study: Guideline / Health_economic_evaluation / Prognostic_studies / Qualitative_research / Risk_factors_studies / Systematic_reviews Aspects: Determinantes_sociais_saude Limits: Humans Language: En Journal: PLoS One Journal subject: CIENCIA / MEDICINA Year: 2019 Document type: Article Affiliation country: Iran Country of publication: United States

Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Health Personnel / Delivery of Health Care / Neoplasms Type of study: Guideline / Health_economic_evaluation / Prognostic_studies / Qualitative_research / Risk_factors_studies / Systematic_reviews Aspects: Determinantes_sociais_saude Limits: Humans Language: En Journal: PLoS One Journal subject: CIENCIA / MEDICINA Year: 2019 Document type: Article Affiliation country: Iran Country of publication: United States