Improving quality and reducing costs in a practice are two of the Oncology Care Model’s (OCM) key goals, and one of the best ways to achieve them is to reduce unnecessary emergency department (ED) visits and hospitalizations. During a study presented at the 2018 American Society of Clinical Oncology Annual Meeting, researchers described a campaign implemented to reach those objectives.

Researchers improved the education provided to nurses and advanced practice providers (APPs) prior to patients’ start of treatment, called the OCM Treatment Planning visit. They also implemented new triage pathways, including 38 symptom pathways and 27 follow-up pathways. The pathways were modifications of the COME HOME model that was created to improve outcomes and enhance patient care.

Through this process, medical staff also made symptom follow-up calls to prevent emergency admissions. APP staffing was increased to provide blocks of time without schedule disruptions on the day of patients’ visits. Patients were also highly encouraged in verbal and written instructions to call medical staff before going to the ED.

Results that the campaign was successful in reducing the acute care admissions rate by 16%.

“By implementing a cost efficient, reproducible, and scalable campaign targeting ED avoidance and hospitalizations, we were able to decrease hospital admissions,” the authors said. “Reported Medicare savings amounted to nearly $798,000 in inpatient cost per quarter over 1,600 patients.”

 

Baseline

January–March 2016

Year One

July 2016–June 2017

Year One Benchmark

(Risk Cohort)

Patients per quarter

1,722

1,600

-

Mean patient risk score

2.999

3.000

> 2.724

Admissions per 100 patients, per quarter

27.0

22.6

25.9

Cost per admission event

11,122

11,106

-

Inpatient cost per patient, per quarter

3,003

2,505

-

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