Mercy Cancer Care



Mercy Cancer Care
St. Louis, Missouri

Reducing ED Visits and Hospital Admissions after Chemotherapy with Predictive Modeling of Risk Factors

After conducting a retrospective review to identify clinical variables associated with increased risk of hospital admissions and emergency department visits, Mercy Cancer Care used these data to develop and implement a predictive algorithm that stratifies patients according to their 30-day risk of both events. A daily dashboard report identifies all patients as high, intermediate, or low risk. These dashboard risk scores are then used to proactively manage patients with referrals to services such as social work, dietitian, or evaluation for possible home care assistance. Ultimately, this QI initiative effort will allow proactive management of patients within 30 days of their outpatient chemotherapy—the OP 35 bundling payment initiative that CMS put into effect this year under its Hospital Outpatient Quality Reporting Program.

To hear this ACCC Innovator Award session on-demand, please visit the ACCC eLearning portal.

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Reducing Readmissions After Chemotherapy

innovatorAwards-2020-sealSingular-80x80Quality measure OP-35—the first chemo-specific measure in the Centers for Medicare & Medicaid Services Hospital Outpatient Quality Reporting Program—went into effect for payment determination this year. To be fully prepared, Mercy Cancer Care looked at 90,000 of their qualifying chemotherapy visits that met the criteria for measure OP-35 and identified the clinical variables associated with patients’ increased risk of hospital admissions or ED visits. Based on that data, Mercy developed a predictive algorithm that identifies and manages chemotherapy patients who are at high risk.
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Featured in Oncology Issues

v36n4-reducing-ed-visits-and-hospital-admissions-after-chemotherapy-with-predictive-modeling-of-risk-factors-oncology-issuesReducing ED Visits and Hospital Admissions after Chemotherapy with Predictive Modeling of Risk Factors

Approximately 1.76 million people were diagnosed with cancer in the United States in 2019, and new technology and treatments have helped to increase our national five-year survival rates to 70 percent, up from 39 percent in 1960.1 To better meet the needs of this growing patient population, providers have changed how they manage oncology patients. The most common patient concern today is the fear of financial toxicity from increasing drug costs and associated treatment costs; too many patients with cancer are concerned about going bankrupt or, even worse, taking their families into bankruptcy with them due to these high costs of care.
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