Research identifies predictive link between cancer outcomes and Medicare claims

Cancer survival outcomes are known to vary widely depending on where patients receive treatment and care, but efforts to compare hospitals based on long-term survival rates have been unsuccessful due to Medicare claim data that doesn't include information about cancer stages. However, a new study has used risk-adjusted Medicare claims data to calculate long-term survival rates at cancer care providers even without that information.

The research, published in JAMA Oncology, was conducted using data from four different types of hospitals: 11 freestanding cancer hospitals that are exempt from the Medicare prospective payment system; 32 National Cancer Institute-designated cancer centers that are not PPS-exempt; 252 other academic teaching hospitals; and 4,873 remaining hospitals.

Fee-for-service Medicare claims and the SEER Medicare database were the two information sets used, collectively including data on nearly 750,000 cancer patients.

Significant findings included:

  • Patients treated at freestanding cancer hospitals exempt from the prospective payment system have a 10 percent lower chance of dying in their first year than patients treated at other non-teaching hospitals.
  • This survival gap persisted for more than five years. The risk-adjusted five-year survival rates by hospital type were 53 percent for PPS-exempt hospitals; 49 percent for NCI-designated cancer centers; 46 percent for academic teaching hospitals; and 44 percent for other hospitals.

"Patients need reliable information about hospitals' survival rates so they can make informed choices about their care," David G. Pfister, MD, chief of Memorial Sloan Kettering's head and neck oncology service and lead author of the study, said in a statement. "But similarly important, measuring the differences in survival rates among hospitals is a first step toward improving cancer care at every hospital across the country."

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