Association of Participation in the Oncology Care Model With Medicare Payments, Utilization, Care Delivery, and Quality Outcomes.

Importance: In 2016, the US Centers for Medicare & Medicaid Services initiated the Oncology Care Model (OCM), an alternative payment model designed to improve the value of care delivered to Medicare beneficiaries with cancer.

Objective: To assess the association of the OCM with changes in Medicare spending, utilization, quality, and patient experience during the OCM's first 3 years.

Design, Setting, And Participants: Exploratory difference-in-differences study comparing care during 6-month chemotherapy episodes in OCM participating practices and propensity-matched comparison practices initiated before (January 2014 through June 2015) and after (July 2016 through December 2018) the start of the OCM.

How Do Claims-Based Measures of End-of-Life Care Compare to Family Ratings of Care Quality?

Objectives: Assess whether frequently-used claims-based end-of-life (EOL) measures are associated with higher ratings of care quality.

Design: Retrospective cohort study.

Setting/participants: Deceased fee-for-service Medicare beneficiaries with cancer who underwent chemotherapy during July 2016 to January 2017 and died within 12 months and their caregiver respondents to an after-death survey (n = 2,559).

Early Findings From the Oncology Care Model Evaluation.

Purpose: The Oncology Care Model (OCM) is an alternative payment model administered by the Centers for Medicare & Medicaid Services (CMS) that is structured around 6-month chemotherapy treatment episodes. This report describes the CMS-sponsored OCM evaluation and summarizes early evaluation findings.

Methods: The OCM evaluation examines health care spending and use, quality of care, and patient experience during chemotherapy treatment episodes.

Proportion and Patterns of Hospice Discharges in Medicare Advantage Compared to Medicare Fee-for-Service.

Background: When Medicare Advantage (MA) patients elect hospice, all covered services are reimbursed under the Medicare fee-for-service (FFS) program. This financial arrangement may incentivize MA plans to refer persons to hospice near end of life when costs of care typically rise.

Objective: To characterize hospice discharge patterns for MA versus FFS patients and examine whether patterns differ by MA concentration across hospital referral regions (HRRs).

A National Study of Live Hospice Discharges between 2000 and 2012.

Background: Live hospice discharges represent a potential vulnerability in the Medicare hospice benefit. Little is known about how live discharges have varied over time.

Objective: To identify trends in live hospice discharges between 2000 and 2012.

Volume Matters: Returning Home After Hip Fracture.

Objectives: To examine the effect of the relationship between volume (number of hip fracture admissions during the 12 months before participant's fracture) and other facility characteristics on outcomes.

Design: Prospective observational study.

Setting: U.

An Examination of the First 30 Days After Patients are Discharged to the Community From Hip Fracture Postacute Care.

Background: Postacute care (PAC) rehabilitation aims to maximize independence and facilitate a safe community transition. Yet little is known about PAC patients' success in staying home after discharge or differences on this outcome across PAC providers.

Objectives: Examine the percentage of PAC patients who remain in the community at least 30 days after discharge (ie, successful community discharge) after hip fracture rehabilitation and describe differences among PAC facilities based on this outcome.

What happens to patients when they fracture their hip during a skilled nursing facility stay?

Objectives: To characterize outcomes of patients experiencing a fall and subsequent hip fracture while in a nursing home receiving skilled nursing facility (SNF) services.

Design: Observational study.

Participants: Short-stay fee-for-service Medicare beneficiaries who experienced their first hip fracture during an SNF stay.

Automobile commuting duration and the quantity of time spent with spouse, children, and friends.

Objective: To explore the extent to which commuters reallocate time away from their spouse, children, and friends.

Methods: An analytic sample of adult, full-time employed, urban-dwelling respondents is drawn from the nationally representative American Time Use Survey (2003-2010). Seemingly Unrelated Regressions are utilized to calculate adjusted mean number of daily minutes spent with spouse, own children, and friends at several commuting durations.

Trade-offs between commuting time and health-related activities.

To further understand documented associations between obesity and urban sprawl, this research describes individuals' trade-offs between health-related activities and commuting time. A cross-section of 24,861 working-age individuals employed full-time and residing in urban counties is constructed from the American Time Use Survey (2003-2010). Data are analyzed using seemingly unrelated regressions to quantify health-related activity decreases in response to additional time spent commuting.