Grant Number:	5R01CA114204-03 Interpret this number
Primary Investigator:	Hornbrook, Mark
Organization:	Kaiser Foundation Research Institute
Project Title:	Medical Care Burden of Cancer: System and Data Issues
Fiscal Year:	2009

DESCRIPTION (provided by applicant): The total medical costs of cancers are about 5% of national health care expenditures and 10% of Medicare outlays. Much of what we know about cancer costs comes from the National Cancer Institute's Surveillance, Epidemiology, and End Results (SEER) cancer registries linked to Medicare claims (SEER- Medicare). While the SEER-Medicare link represents the experience of 85% of Aged Medicare beneficiaries enrolled in the fee-for-service (FFS) indemnity option, the link omits the experience of the 15% of seniors enrolled in Medicare HMOs. These groups differ: 1) HMO providers face different incentives; 2) HMO Medicare beneficiaries generally have better benefits; 3) given that FFS vs. HMO choice is voluntary, the 2 populations may differ in their health status and preferences in ways that are difficult to measure. In addition, utilization and costs for Medicare Working Aged beneficiaries may be under-reported in SEER-Medicare. These factors may cause selection and omission biases in cancer cost estimates based on ether group alone. Building on the Cancer Research Network, we will develop a multi-site, multi-payer database to support analyses extending and complementing the SEER-Medicare link by addressing 3 aims: Aim 1 - Descriptive Analyses: Estimate the incremental medical care cost of all cancers, and selected cancers, broken down by cancer site, phase of treatment, stage at diagnosis, cancer type (fatal vs. non- fatal), patient demographics, co-morbidity, and source of health insurance for the years 2000-2007 in 4 large integrated health care systems. Aim 2 - Omissions Bias: Estimate the costs of each cancer care component for Aged Medicare HMO beneficiaries that is omitted from SEER-Medicare: a) non-Medicare covered services; b) effects of health care for seniors whose cancers were diagnosed before age 65; c) cancer screening services; d) cancer prevention services; e) changes in benefits, if any, associated with switching from private health insurance to Medicare; and f) employer-covered benefits for Working Aged beneficiaries. Aim 3 - Selection Bias: Estimate the incremental medical care costs of all cancers, as well as selected cancers, for SEER-Medicare over 2000-2007. Model the determinants of cancer costs across HMO and FFS systems for Medicare Aged beneficiaries, correcting for selection and omissions biases. We hypothesize that HMO/FFS system differences, benefit differences, and omissions biases will account for a larger proportion of cancer costs that those from selection biases. This study will update the information on the medical care costs of cancer for Aged Medicare beneficiaries. We will also learn how cancer care varies between Medicare's FFS and HMO options.




Medical Care Costs Associated With Cancer in Integrated Delivery Systems.
Authors: Banegas M.P. , Yabroff K.R. , O'Keeffe-Rosetti M.C. , Ritzwoller D.P. , Fishman P.A. , Salloum R.G. , Lafata J.E. , Hornbrook M.C. .
Source: Journal Of The National Comprehensive Cancer Network : Jnccn, 2018 04; 16(4), p. 402-410.
PMID: 29632060
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Detecting Lung and Colorectal Cancer Recurrence Using Structured Clinical/Administrative Data to Enable Outcomes Research and Population Health Management.
Authors: Hassett M.J. , Uno H. , Cronin A.M. , Carroll N.M. , Hornbrook M.C. , Ritzwoller D. .
Source: Medical Care, 2017 12; 55(12), p. e88-e98.
PMID: 29135771
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Preventive Care Receipt And Office Visit Use Among Breast And Colorectal Cancer Survivors Relative To Age- And Gender-matched Cancer-free Controls
Authors: Lafata J.E. , Salloum R.G. , Fishman P.A. , Ritzwoller D.P. , O'Keeffe-Rosetti M.C. , Hornbrook M.C. .
Source: Journal Of Cancer Survivorship : Research And Practice, 2015 Jun; 9(2), p. 201-7.
PMID: 25252623
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Advanced Imaging Among Health Maintenance Organization Enrollees With Cancer
Authors: Loggers E.T. , Fishman P.A. , Peterson D. , O'Keeffe-Rosetti M. , Greenberg C. , Hornbrook M.C. , Kushi L.H. , Lowry S. , Ramaprasan A. , Wagner E.H. , et al. .
Source: Journal Of Oncology Practice / American Society Of Clinical Oncology, 2014 Jul; 10(4), p. 231-8.
PMID: 24844241
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Positron Emission Tomography And Stage Migration In Head And Neck Cancer
Authors: VanderWalde N.A. , Salloum R.G. , Liu T.L. , Hornbrook M.C. , O'Keeffe Rosetti M.C. , Ritzwoller D.P. , Fishman P.A. , Elston Lafata J. , Khandani A.H. , Chera B.S. .
Source: Jama Otolaryngology-- Head & Neck Surgery, 2014 Jul; 140(7), p. 654-61.
PMID: 24875939
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Comparative Effectiveness Of Adjunctive Bevacizumab For Advanced Lung Cancer: The Cancer Research Network Experience
Authors: Ritzwoller D.P. , Carroll N.M. , Delate T. , Hornbrook M.C. , Kushi L. , Bowles E.J. , Loggers E.T. , Menter A. .
Source: Journal Of Thoracic Oncology : Official Publication Of The International Association For The Study Of Lung Cancer, 2014 May; 9(5), p. 692-701.
PMID: 24633407
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A Meta-analysis Of Randomized Trials: Immediate Stent Placement Vs. Surgical Bypass In The Palliative Management Of Malignant Biliary Obstruction
Authors: Glazer E.S. , Hornbrook M.C. , Krouse R.S. .
Source: Journal Of Pain And Symptom Management, 2014 Feb; 47(2), p. 307-14.
PMID: 23830531
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Diffusion Of Intraperitoneal Chemotherapy In Women With Advanced Ovarian Cancer In Community Settings 2003-2008: The Effect Of The Nci Clinical Recommendation
Authors: Bowles E.J. , Wernli K.J. , Gray H.J. , Bogart A. , Delate T. , O'Keeffe-Rosetti M. , Nekhlyudov L. , Loggers E.T. .
Source: Frontiers In Oncology, 2014; 4, p. 43.
PMID: 24653978
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Validation Of Electronic Data On Chemotherapy And Hormone Therapy Use In Hmos
Authors: Ritzwoller D.P. , Carroll N. , Delate T. , O'Keeffe-Rossetti M. , Fishman P.A. , Loggers E.T. , Aiello Bowles E.J. , Elston-Lafata J. , Hornbrook M.C. .
Source: Medical Care, 2013 Oct; 51(10), p. e67-73.
PMID: 22531648
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When Does An Episode Of Care For Cancer Begin?
Authors: Hornbrook M.C. , Fishman P.A. , Ritzwoller D.P. , Elston-Lafata J. , O'Keeffe-Rosetti M.C. , Salloum R.G. .
Source: Medical Care, 2013 Apr; 51(4), p. 324-9.
PMID: 23222500
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The Challenge Of Conducting Comparative Effectiveness Research In Cancer: The Impact Of A Fragmented U.s. Health-care System
Authors: Fishman P.A. , Hornbrook M.C. , Ritzwoller D.P. , O'Keeffe-Rosetti M.C. , Lafata J.E. , Salloum R.G. .
Source: Journal Of The National Cancer Institute. Monographs, 2013; 2013(46), p. 99-105.
PMID: 23962513
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A Standardized Relative Resource Cost Model For Medical Care: Application To Cancer Control Programs
Authors: O'Keeffe-Rosetti M.C. , Hornbrook M.C. , Fishman P.A. , Ritzwoller D.P. , Keast E.M. , Staab J. , Lafata J.E. , Salloum R. .
Source: Journal Of The National Cancer Institute. Monographs, 2013; 2013(46), p. 106-16.
PMID: 23962514
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Changes in body mass index and stoma related problems in the elderly.
Authors: Skeps R. , McMullen C.K. , Wendel C.S. , Bulkley J. , Grant M. , Mohler J. , Hornbrook M.C. , Krouse R.S. , Herrinton L.J. .
Source: Journal Of Geriatric Oncology, 2013 Jan; 4(1), p. 84-9.
PMID: 24071496
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Patterns And Predictors Of First-line Chemotherapy Use Among Adults With Advanced Non-small Cell Lung Cancer In The Cancer Research Network
Authors: Ritzwoller D.P. , Carroll N.M. , Delate T. , Hornbrook M.C. , Kushi L. , Aiello Bowles E.J. , Freml J.M. , Huang K. , Loggers E.T. .
Source: Lung Cancer (amsterdam, Netherlands), 2012 Dec; 78(3), p. 245-52.
PMID: 23022316
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Adherence To Surveillance Care Guidelines After Breast And Colorectal Cancer Treatment With Curative Intent
Authors: Salloum R.G. , Hornbrook M.C. , Fishman P.A. , Ritzwoller D.P. , O'Keeffe Rossetti M.C. , Elston Lafata J. .
Source: Cancer, 2012-11-15 00:00:00.0; 118(22), p. 5644-51.
PMID: 22434568
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Survival Among Non-small Cell Lung Cancer Patients With Poor Performance Status After First Line Chemotherapy
Authors: Salloum R.G. , Smith T.J. , Jensen G.A. , Lafata J.E. .
Source: Lung Cancer (amsterdam, Netherlands), 2012 Sep; 77(3), p. 545-9.
PMID: 22633939
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Factors Associated With Adherence To Chemotherapy Guidelines In Patients With Non-small Cell Lung Cancer
Authors: Salloum,R.G. , Smith,T.J. , Jensen,G.A. , Lafata,J.E. .
Source: Lung Cancer (amsterdam, Netherlands), 2012 Feb; 75(2), p. 255-60.
PMID: 21816502
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Using Claims-based Measures To Predict Performance Status Score In Patients With Lung Cancer
Authors: Salloum,R.G. , Smith,T.J. , Jensen,G.A. , Lafata,J.E. .
Source: Cancer, 2011-03-01 00:00:00.0; 117(5), p. 1038-48.
PMID: 20957722
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Assigning Resources To Health Care Use For Health Services Research: Options And Consequences
Authors: Fishman,P.A. , Hornbrook,M.C. .
Source: Medical Care, 2009 Jul; 47(7 Suppl 1), p. S70-5.
PMID: 19536002
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