This physician-based health care model, designed to accommodate the schedules of busy specialists, is stressful for patients, and sometimes leads to unnecessary additional or repetitive testing and care that can decrease good outcomes and drive up costs.
In a previous study led by Johns Hopkins radiation oncologist Russell Hales, M.D.—reported at the 2016 ASTRO Annual Meeting—Voong, Hales and their colleagues showed that 139 non-small cell lung cancer patients who received care at Johns Hopkins’ thoracic oncology multidisciplinary clinic had lived nearly 10 months longer on average than 169 patients who were not seen in the special clinic. In the new study, the researchers examined whether the clinic also reduced medical costs.
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Voong and her team gathered detailed financial data from the billing records of the same set of 308 patients, including professional fees—the cost of provider visits, exams and tests—during a 90-day period before any cancer treatment started.
Their updated results showed that, on average, there were no differences in the frequency of PET, CT, or MRI scans between the group that attended the multidisciplinary clinic and the one that didn’t. However, those in the multidisciplinary clinic group received significantly fewer other exams (an average of 3.7 versus 2.8) and saw fewer health care providers (an average of 6.7 versus 4.8). The average cost savings of these fewer professional fee services was about $1,700 per patient.
With the addition of technical fees—those that the hospital itself charges for supplies and services—the savings were even more substantial, estimated at nearly $6,000 per patient.
“If we have a clinic model that improves outcomes and we can tack on a cost savings as well, it’s a win-win,” Voong says. Models like Johns Hopkins’ thoracic oncology multidisciplinary clinic, says Voong, could work for a variety of other diseases at Johns Hopkins and other medical centers.
She and her colleagues plan to study whether savings continue while patients receive treatment.
More than 200,000 people are estimated to be diagnosed with lung cancer this year in the U.S. It is the second most common cancer among adults and causes the most deaths. Less than 20 percent of people diagnosed with lung cancer survive beyond five years.
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