The impact of COVID-19 on patients with cancer in the Oncology Care Model in the U.S. Oncology Network during performance period 8

ABSTRACT

Background: The COVID-19 pandemic had a profound impact on cancer care delivery throughout the nation. Data regarding the outcomes of patients on cancer therapy who had COVID-19 is lacking. The US Oncology Network had 14 practices participating in the Oncology Care Model (OCM) during performance period 8 (PP8) which enrolled patients from 1/2/2020 to 7/1/2020. OCM enrolls patients with Medicare undergoing treatment for a cancer diagnosis. Utilizing OCM claims files, we evaluated the impact of COVID-19 on outcomes and costs for patients enrolled in the OCM during the first stages of the pandemic. Methods: Utilizing claims and episode data from the OCM, we were able to identify episodes with patients who had a positive COVID-19 diagnosis. Episodes were flagged with COVID-19 based on the ICD-10 code U07.1 on claims files. We were then able to compare the total cost of care (TCOC), inpatient costs and death rate to those patients in the OCM that did not have a COVID-19 ICD-10 claim. Results: 2.5% of patient episodes in PP8 had a positive COVID-19 ICD-10 claim. TCOC per episode increased 36% per patient from $34,340 for those without COVID-19 to $53,605 for those with COVID-19, a difference of $19,265 per patient. Inpatient costs increased from $3,276 for those without COVID-19 to $12,226 for those with a COVID-19 diagnosis. 8.9% of patients without a COVID-19 diagnosis died during the episode vs 20.0% of those with a COVID-19 diagnosis. Other costs including the cost of drugs did not significantly differ between the two groups. Conclusions: A diagnosis of COVID-19 for patients in the OCM receiving cancer treatment during PP8 led to a significant increase in costs, especially the costs of hospitalization. The death rate more than doubled for patients with COVID-19 during an OCM episode. Patients with Medicare and cancer undergoing treatment were at high-risk for complications and death from COVID-19 during OCM performance period 8.