For the study, COA and Avalere conducted a retrospective analysis leveraging utilization data from a large, proprietary Inovalon provider-sourced data clearinghouse. The clearinghouse data represent 5-7% of the total volume of Medicare Fee-for-Service (FFS) claims nationally, including CMS-1450 claims from Institutional providers and CMS-1500 claims from Non-Institutional or Professional providers. The analysis sought to characterize changes in utilization of cancer care services and gain insight into the impact of COVID-19 on the U.S. cancer population, including identification of new patients, gaps in access to care, and disruption of treatment journeys. The full data set was then limited to claims that were 1) submitted for adjudication between January 1, 2019 and July 31, 2020, inclusive, and 2) specific to targeted cancer-related services of interest, including diagnostic screenings (breast, colon, etc.), physician office visits, hospitalizations, surgeries, and infusion therapies administered in an outpatient setting, resulting in a sample of 6.2 million Medicare claims. For each service or service category, the number of services billed by each rendering provider was tracked and trended, and the mean change in volume (2019 vs. 2020) was estimated and compared, statistically, using a Wilcoxon rank-sum test. All data manipulation and statistical analyses were carried out using SAS 9.4 (SAS Institute, Cary, NC), assuming a p-value (α) of 0.05.
As the COVID-19 pandemic continues, COA and Avalere will continue to track the pandemic's impact on cancer care and issue updates to the study when new data are available. Given the potential of a third surge of COVID-19 cases in the winter months of 2020, future analytics will need to assess the continued barriers to cancer care and the potential longer-term impact on outcomes.
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The full study can be found online at https://www.asco.org/sites/new-www.asco.org/files/content-files/2020-Patt-10.1200.CCI_.20.00134.pdf.
A summary slide deck of the study findings can be accessed at https://communityoncology.org/jco-covid-cancer-analysis/.
About the Community Oncology Alliance:
COA is a non-profit organization dedicated to advocating for community oncology practices and, most importantly, the patients they serve. COA is the only organization dedicated solely to community oncology where the majority of Americans with cancer are treated. The mission of COA is to ensure that cancer patients receive quality, affordable, and accessible cancer care in their own communities. More than 1.5 million people in the United States are diagnosed with cancer each year and deaths from the disease have been steadily declining due to earlier detection, diagnosis, and treatment.