Lessons From Reporting National Performance Measures in a Regional Setting: Washington State Community Cancer Care Report
Open accessAbstract
Regional public reporting of performance measures in oncology can facilitate local decision making across stakeholders, but small numbers of patients and clinics pose a challenge to creating statistically robust measures. In this article, we describe our development of the Community Cancer Care in Washington State: Quality and Cost Report, the first publicly available report showing clinic-level quality and cost measures at the regional level. We learned key lessons in how to adapt national performance reporting to our regional setting using a registry-linked multipayer claims database. In short, limited numbers of eligible patients for some nationally recognized metrics led us to group metrics and use a 3-year performance window. After completing clinic attribution and other requirements of metric construction, the final metrics included between 62.9% and 88.4% of the eligible patients. To link total costs to some quality measures, we had to define a treatment and surveillance episode of care. Risk adjustment was challenged by the ability to include a limited number of risk adjustors and their potential concentration in a few clinics. We used a different quality score than national performance reporting to account for variation in the range of risk-standardized rates. Current methodology does not permit us to determine whether clinically meaningful differences in quality or costs exist, which inhibits value comparisons. Stakeholder engagement was critical for providing methodologic feedback. In conclusion, we found that refining national metrics was necessary to facilitate public reporting in a regional setting. Further methodologic development can strengthen public reporting and future applications.
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Many commercial payors have oncology patient populations that are too small to perform risk adjustment, limiting alternative payment models' feasibility.
“for example, many commercial payors have oncology patient populations that are too small to perform risk adjustment, limiting alternative payment models’ feasibility [68].”
From Translating economic evaluations into financing strategies for implementing evidence-based practices (2021) · cites this paper as [68]
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Translating economic evaluations into financing strategies for implementing evidence-based practices
Dopp, A. R., Kerns, S. E. U., Panattoni, L., Ringel, J. S., Eisenberg, D., Powell, B. J., Low, R., & Raghavan, R. (2021) · Implementation Science · doi:10.1186/s13012-021-01137-9 · Cited by 52 · see citing works
Self-citation
- Authors
- Panattoni, L., Fedorenko, C., Kreizenbeck, K., Sun, Q., Li, L., Conklin, T., Lyman, G. H., & Ramsey, S. D.
- Affiliations
- University of Washington (US)
- Corresponding author
- Panattoni, Laura
- Venue
- Journal of Oncology Practice
- Published
- 2018-12
- Volume
- 14
- Issue
- 12
- Pages
- e801-e814
- ISSN
- 1554-7477 (ISSN-L)
- 1935-469X
- OpenAlex
- W2904194586
- Cited by
- 6
- References
- 10
- Citations by year
- 2026: 1 · 2025: 2 · 2021: 2 · 2018: 1
- FWCI
- 0.94
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Journal of Oncology Practice (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Health Professions › Health Information Management › Healthcare Quality and Management
- Health Sciences › Health Professions › General Health Professions › Patient Satisfaction in Healthcare
- Health Sciences › Health Professions › General Health Professions › Primary Care and Health Outcomes
- Keywords
- public reporting, performance indicators, community oncology, quality of cancer care, cancer care costs, risk adjustment, stakeholder engagement, Washington State
- MeSH terms
- Humans, Medical Oncology, Neoplasms, Washington, Quality Indicators, Health Care
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