Grant Number:	1R01CA168691-01A1 Interpret this number
Primary Investigator:	Hollenbeck, Brent
Organization:	University Of Michigan At Ann Arbor
Project Title:	Impact of Urologist Practice Structure on Prostate Cancer Care
Fiscal Year:	2013

DESCRIPTION (provided by applicant): Prostate cancer is a common and expensive disease with annual spending topping $12 billion. During the past decade, prostate cancer spending has increased by 11% annually, outpacing growth rates for other common conditions such as cardiovascular and pulmonary diseases. This growth is due, in part, to financial incentives afforded by urologist self-referral of diagnostic and therapeutic services. The recent proliferatio of large urology groups has the potential to further amplify these trends. The formation of these large groups has been propagated by their unique investment opportunities, such as ownership interests in expensive equipment to provide intensity modulated radiation therapy and cross-sectional imaging. However, proponents argue that their "one-stop" model results in better care integration for men with prostate cancer, ultimately yielding better quality at a lower cost. Thus, the goal of this national study is to better understand relationships between urologist practice organization and the quantity, quality and cost of prostate cancer care. To examine this issue more carefully, this grant has the following three aims. Aim 1. To assess relationships between urologist practice organization and prostate cancer utilization. Using national Medicare and SEER-Medicare data, we will measure how prostate cancer detection and treatment are mediated by urologist group practice structure. Aim 2. To measure relationships between urologist practice organization and the quality of prostate cancer care. Using similar methods, we will determine the effect of urologist practice structure on the quality of prostate cancer care including adherence to nationally endorsed standards and the breadth of overuse. Aim 3. To assess relationships between urologist practice organization and prostate cancer expenditures. We will measure the association between urologist practice structure and national Medicare payments, both per capita (i.e., average overall spending) and per episode surrounding local treatment. This proposal has real-world implications for all prostate cancer stakeholders. First, our findings with respect to quality have immediate implications for patients, who are logically interested in mechanisms for improving the quality of prostate care delivered. Second, understanding the relative efficiency of prostate cancer care is of immediate interest to payers and policymakers as they explore strategies to improve quality while limiting unnecessary spending growth.




National Trends in Active Surveillance for Prostate Cancer: Validation of Medicare Claims-based Algorithms.
Authors: Modi P.K. , Kaufman S.R. , Qi J. , Lane B.R. , Cher M.L. , Miller D.C. , Hollenbeck B.K. , Shahinian V.B. , Dupree J.M. .
Source: Urology, 2018 Oct; 120, p. 96-102.
EPub date: 2018-07-07.
PMID: 29990573
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Predictors and Cost of Readmission in Total Knee Arthroplasty.
Authors: Urish K.L. , Qin Y. , Li B.Y. , Borza T. , Sessine M. , Kirk P. , Hollenbeck B.K. , Helm J.E. , Lavieri M.S. , Skolarus T.A. , et al. .
Source: The Journal of arthroplasty, 2018 Sep; 33(9), p. 2759-2763.
EPub date: 2018-04-17.
PMID: 29753618
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The Fate of Radical Cystectomy Patients after Hospital Discharge: Understanding the Black Box of the Pre-readmission Interval.
Authors: Krishnan N. , Li B. , Jacobs B.L. , Ambani S.N. , Borza T. , He C. , Hollenbeck B.K. , Morgan T. , Hafez K.S. , Weizer A.Z. , et al. .
Source: European urology focus, 2018 Sep; 4(5), p. 711-717.
EPub date: 2016-08-04.
PMID: 28753778
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Impact of Accountable Care Organizations on Diagnostic Testing for Prostate Cancer.
Authors: Luckenbaugh A.N. , Hollenbeck B.K. , Kaufman S.R. , Yan P. , Herrel L.A. , Skolarus T.A. , Norton E.C. , Schroeck F.R. , Jacobs B.L. , Miller D.C. , et al. .
Source: Urology, 2018 Jun; 116, p. 68-75.
EPub date: 2018-04-06.
PMID: 29630957
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Urologist Practice Affiliation and Intensity-modulated Radiation Therapy for Prostate Cancer in the Elderly.
Authors: Hollenbeck B.K. , Kaufman S.R. , Yan P. , Herrel L.A. , Borza T. , Schroeck F.R. , Jacobs B.L. , Skolarus T.A. , Shahinian V.B. .
Source: European urology, 2018 Apr; 73(4), p. 491-498.
EPub date: 2017-08-18.
PMID: 28823605
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Early effect of Medicare Shared Savings Program accountable care organization participation on prostate cancer care.
Authors: Borza T. , Kaufman S.R. , Yan P. , Herrel L.A. , Luckenbaugh A.N. , Miller D.C. , Skolarus T.A. , Jacobs B.L. , Hollingsworth J.M. , Norton E.C. , et al. .
Source: Cancer, 2018-02-01; 124(3), p. 563-570.
EPub date: 2017-10-20.
PMID: 29053177
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Accountable care organizations and prostate cancer care.
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Source: Urology practice, 2017 Nov; 4(6), p. 454-461.
EPub date: 2016-11-10.
PMID: 29170755
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Reimbursement and use of intensity-modulated radiation therapy for prostate cancer.
Authors: Shahinian V.B. , Kaufman S.R. , Yan P. , Herrel L.A. , Borza T. , Hollenbeck B.K. .
Source: Medicine, 2017 Jun; 96(25), p. e6929.
PMID: 28640073
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Sharp Decline In Prostate Cancer Treatment Among Men In The General Population, But Not Among Diagnosed Men.
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Source: Health affairs (Project Hope), 2017-01-01; 36(1), p. 108-115.
PMID: 28069853
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Health Care Integration and Quality among Men with Prostate Cancer.
Authors: Herrel L.A. , Kaufman S.R. , Yan P. , Miller D.C. , Schroeck F.R. , Skolarus T.A. , Shahinian V.B. , Hollenbeck B.K. .
Source: The Journal of urology, 2017 Jan; 197(1), p. 55-60.
EPub date: 2016-07-15.
PMID: 27423758
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Implications of evolving delivery system reforms for prostate cancer care.
Authors: Hollenbeck B.K. , Bierlein M.J. , Kaufman S.R. , Herrel L. , Skolarus T.A. , Miller D.C. , Shahinian V.B. .
Source: The American journal of managed care, 2016 Sep; 22(9), p. 569-75.
PMID: 27662220
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Managed care and the dissemination of robotic prostatectomy.
Authors: Zhang Y. , Hollenbeck B.K. , Schroeck F.R. , Jacobs B.L. .
Source: Surgical innovation, 2014 Dec; 21(6), p. 566-71.
EPub date: 2014-07-21.
PMID: 25049319
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Regional variation in quality of prostate cancer care.
Authors: Schroeck F.R. , Kaufman S.R. , Jacobs B.L. , Skolarus T.A. , Hollingsworth J.M. , Shahinian V.B. , Hollenbeck B.K. .
Source: The Journal of urology, 2014 Apr; 191(4), p. 957-62.
EPub date: 2013-10-19.
PMID: 24144685
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Technology diffusion and diagnostic testing for prostate cancer.
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Source: The Journal of urology, 2013 Nov; 190(5), p. 1715-20.
EPub date: 2013-05-10.
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Use of advanced treatment technologies among men at low risk of dying from prostate cancer.
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Source: JAMA, 2013-06-26; 309(24), p. 2587-95.
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