Impact of a cancer management program.

227 Background: US Oncology, Inc., Texas Oncology (TxO) and Aetna are engaged in a pilot program, Innovent Oncology (IOP) to evaluate clinical and financial impacts of Pathways (PW), a nursing call intervention for chemotherapy patients (pt support services-PSS), and an advance care planning (ACP) initiative. We report quality initiatives, PW compliance and ACP, from the program at 18 months, and IP and ER admits at 12 months. Methods: Eligible Aetna pts with PW diagnoses, treated by TxO were enrolled. PW compliance was tracked. PSS calls occurred at regular intervals during chemotherapy. Symptoms, quality of life, and depression were screened each call with referrals to TxO as needed for management. ACP was initiated in month 2 of IOP. To support IOP, a leadership team comprising physicians, pharmacists and nurses was established. IP,ER data on predefined subgroups were compared to diagnosis-adjusted rates from the baseline prior year. Results: The program enrolled 184 patients from June 1, 2010 – Decembe 30, 2011 with 278 regimens ordered. Pathway adherence improved from 67% to 75%. 81% enrolled in PSS; of these, 83% were introduced to ACP, with 11% (n=16) completing a full ACP discussion. PSS made 906 calls to pts and assessed pain at 80% of contacts. IP, ER utilization rates after 12 months of IOP are reported (see Table). Conclusions: This is a preliminary evaluation with small numbers. Results suggest cancer patients can be identified pre-treatment; a proactive nurse call system is feasible and well received; a symptom assessment tool can be systematically implemented, communication on ACP initiated; and a pathways program enhanced. A reduction of ER visits by 39.8%, IP admits by 16.5 %, and inpatient days/member by 35.9% are very promising trends. A bootstrap shows 97% of scenarios with IP utilization reduction, and 96% with ER utilization reduction. [Table: see text]