To assess the cost‐effectiveness of implementing a patient navigation () program with capitated payment for Medicare beneficiaries diagnosed with lung cancer.
Data Sources/Study Setting
Cost‐effectiveness analysis.
A Markov model to capture the disease progression of lung cancer and characterize clinical benefits of services as timeliness of treatment and care coordination. Taking a payer's perspective, we estimated the lifetime costs, life years (s), and quality‐adjusted life years (s) and addressed uncertainties in one‐way and probabilistic sensitivity analyses.
Data Collection/Extraction Methods
Model inputs were extracted from the literature, supplemented with data from a Centers for Medicare and Medicaid Services demonstration project.
Compared to usual care, services incurred higher costs but also yielded better outcomes. The incremental cost and effectiveness was $9,145 and 0.47 s, respectively, resulting in an incremental cost‐effectiveness ratio of $19,312/. One‐way sensitivity analysis indicated that findings were most sensitive to a parameter capturing survival benefit for local‐stage patients. ‐acceptability curve showed the probability that the program was cost‐effective was 0.80 and 0.91 at a societal willingness‐to‐pay of $50,000 and $100,000/, respectively.
Instituting a capitated program is cost‐effective for lung cancer patients in Medicare. Future research should evaluate whether the same conclusion holds in other cancers.
