Franklin Gaylis, MD, presented “Pay for Performance Model to Improve Quality of Active Surveillance in Low-Risk Prostate Cancer” for the Grand Rounds in Urology audience in June 2021.

How to cite: Gaylis, Franklin. “Pay for Performance Model to Improve Quality of Active Surveillance in Low-Risk Prostate Cancer” June 2021. Accessed Sep 2021. https://grandroundsinurology.com/pay-for-performance-model-to-improve-quality-of-active-surveillance-in-low-risk-prostate-cancer/

Pay for Performance Model to Improve Quality of Active Surveillance in Low-Risk Prostate Cancer – Summary:

In the final installment of a 3-part series, Franklin Gaylis, MD, FACS, Chief Scientific Officer of Genesis Healthcare Partners and Voluntary Professor of Urology at the University of California, San Diego, reviews measures derived from a project looking at the value of a pay for performance model in improving the quality of active surveillance in low-risk prostate cancer. He explains that this project, which was a collaboration between UnitedHealthcare and Genesis Healthcare Partners, resulted in four measures for determining the success of this pay for performance model. The first bar to be cleared is that doctors have to test at least 90% of patients using the electronic medical record (EMR)-embedded template. The other three measures call for physicians to adopt active surveillance or watchful waiting for at least 75% of patients with low-risk prostate cancer, to conduct PSA tests biannually on at least 75% of those patients on active surveillance, and to also perform confirmatory biopsy on at least 75% of the patients on active surveillance within 18 months. Dr. Gaylis then looks at the utility of the EMR-embedded template itself, noting that it is easy to use and can accurately capture a patient’s risk category and tumor stage. He also observes that its metrics are essentially available on demand, and using it can result in a 26-fold decrease in cost compared to quarterly data abstraction. Dr. Gaylis concludes by reiterating that the US healthcare system is transitioning from volume to value, and notes that collaborative efforts between physicians and the government, like the UnitedHealthcare/Genesis project, may result in the best standards and practices for the country.

Part of this series 1 can be viewed here, while part two can be seen here.

Disclosure: Dr. Gaylis has an ownership stake in GenIT LLC, which owns WizMD, a software program created at Genesis Healthcare Partners that is used for data extraction. It currently has no significant value.