The study revealed that the most common reason cancer patients visited an ED was due to pain. In fact, visits due to pain amounted to 27 percent of overall visits and had a median cost per visit of $1,127. Fever and difficulty breathing were the next two most common reasons that brought patients to the ED, each at 6 percent.

Overall, the study indicated a higher median cost per visit for cancer patients compared with the cost of visits as a result of other chronic health conditions. The median cost per visit of preventable cancer-related symptoms was $1,047 compared to a median cost per visit of $335 for symptoms related to a chronic health condition.


"This represents a rare opportunity to reduce costs and improve patient outcomes" said Panattoni, noting that investment in sharing best practices and new models of care will likely be necessary to make a significant difference.

One limitation of the study is that it did not include data from patients insured through Medicare. The team expects to receive that data in the coming months and incorporate it into these findings.

Novel partnerships drive research

Under the leadership of Dr. Scott Ramsey, HICOR has developed a network of providers and insurers who routinely share healthcare claims and cost data in an effort to improve cancer care.

"HICOR has facilitated a collaborative environment where payers and delivery systems work together and share data," said Panattoni. "This allows us to identify priority areas to improve care and develop shared solutions."

HICOR has also established a community working group -- including patient representatives --focused on reducing ED and hospital use for patients undergoing treatment. The working group makes recommendations for research priorities and new, patient-centered models of care, including investment in proactive symptom management.

Panattoni pointed to oncology medical home models and cancer-specific urgent care centers as an approach better suited to addressing patient symptoms. Such models strive to deliver value-based care, a departure from the historic focus in oncology on volume-based care. They include features such as expanded hours, same-day visits, electronic outreach to patients and team care.

Panattoni and her HICOR colleagues plan to focus next on the financial burden patients experience through out-of-pocket costs due to preventable ED visits, which could particularly affect those patients on high-deductible insurance plans. Including data from more diverse socioeconomic and geographic groups, along with following patients for longer, would make the data more applicable to a larger population.

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