A year later, when the hospital examined those numbers again, they’d improved—often significantly—or at least had not gotten worse. One finding was that even though metrics such as length of stay and return to the operating room improved, blood use increased. The center is now conducting research to determine the reasons for that increase.
When it comes to cost, the main drivers are the treatment modalities and co-morbid conditions, not disease site or stage, Dr. Weber said. “You have to know your cost of care before you can enter into a bundled payment scheme, and you have to maintain a reasonable margin because if there’s no margin, there’s no mission,” he said. MD Anderson has built in a stop-loss on cases that are extreme outliers, he said.
Palliative Care Specialists
Jonas Johnson, MD, professor and chair of otolaryngology at the University of Pittsburgh School of Medicine, made powerful remarks on acknowledging when patients may have hit the end of the line with aggressive treatment. In those cases, having a palliative care representative on a tumor board is immensely helpful, he said.