Global Budget Revenue Model and Care for Patients Receiving Chemotherapy

How did Maryland’s Global Budget Revenue (GBR) model affect the payments, hospital utilization, and quality of care for Medicare beneficiaries undergoing systemic therapy for cancer?In this cohort study of 77 062 total chemotherapy episodes, the GBR model’s implementation was associated with a relative reduction in total Medicare payments, hospital-based payments, and chemotherapy-related hospitalizations in Maryland compared with control states, along with a larger increase in professional payments during 6 months of systemic therapy episodes. Measures of quality of care did not change.The findings of this study suggest that Maryland’s GBR model achieved substantial reductions in the growth of Medicare payments for patients undergoing systemic therapy for cancer, possibly by shifting care toward lower-cost treatment settings.

Corresponding Author: Anaeze C. Offodile, II, MD, MPH, Plastic and Reconstructive Surgery Service, Memorial Sloan Kettering Cancer Center, 1275 York Ave, New York, NY 10065 (offodia@mskcc.org).

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