Associations between healthcare costs and care experiences among older adults with and without cancer

• Published in: Journal of geriatric oncology 2023-09, Vol.14 (7), p.101561-101561, Article 101561
• Main Authors: Allaire, Benjamin T., Zabala, Diana, Lines, Lisa M., Williams, Courtney, Halpern, Michael, Mollica, Michelle
• Format: Article
• Language: English
• Subjects: Aged; cancer; Care coordination; Health Care Costs; Health Expenditures; Humans; Medicare; Neoplasms - therapy; Physician communication; Surveys and Questionnaires; United States
• ISSN: 1879-4068; 1879-4076; 1879-4076
• DOI: 10.1016/j.jgo.2023.101561

Care coordination and patient-provider communication are important for older adults with cancer, as they likely have additional, non-cancer chronic conditions requiring consultation across multiple providers. Suboptimal care coordination and patient-provider communication can lead to costly and preventable adverse outcomes. This study examines Medicare expenditures associated with patient-reported care coordination and patient-provider communication among older adults with and without cancer. We explore SEER-CAHPS® (Surveillance, Epidemiology and End Results-Consumer Assessment of Healthcare Providers and Systems) linked data for differences in health care expenditures by care coordination and patient-provider communication experiences for beneficiaries with and without cancer. The cancer cohort included beneficiaries with ten prevalent cancer types diagnosed 2011–2019 at least six months before completing a CAHPS survey. Medicare expenditures were abstracted from Medicare claims data. Care coordination and patient-provider communication composite scores (range 0–100, higher scores indicate better experiences) were patient-reported in the CAHPS® survey. We estimated expenditure differences per one-point change in composite scores for patients with and without cancer. Our analysis included 16,778 matched beneficiaries with and without a previously diagnosed cancer (N = 33,556). Higher care coordination and patient-provider communication scores were inversely associated with Medicare expenditures among beneficiaries with and without cancer in the six months prior to survey response, ranging from -$83 (standard error [SE] = $7) to -$90 (SE = $6) per month. Six months post-survey, expenditures estimates ranging -$88 (SE = $6) to -$106 (SE = $8) were found. We found that lower Medicare expenditures were associated with higher care coordination and patient-provider communication scores. As the number of survivors living longer both with and beyond their cancer grows, addressing their multifaceted care and improving outcomes will be critical.