# Assessing Variation in Outcomes for Cancer Patients Receiving Radiation Treatments and Identifying High-Value Radiation Oncology Practices

> **NIH NIH K08** · BRIGHAM AND WOMEN'S HOSPITAL · 2024 · $270,369

## Abstract

Project Summary/Abstract
The overall goal of this NCI K08 career development proposal is to facilitate Dr. Miranda Lam’s development into an
independent investigator in oncology health policy research focused on understanding factors and policies that impact the
quality and cost of cancer care. Her proposed project aims to characterize the variation in radiation oncology spending,
utilization, and quality across the U.S. and identify strategies used by high-value radiation oncology practices.
The primary objectives are to 1) identify and characterize variation in radiation oncology spending, utilization, and quality
for cancer patients undergoing radiation therapy, 2) specifically investigate whether disparities in spending, utilization and
quality of radiation oncology exist for dual-eligible patients, who are older on Medicare and low-income or disabled on
Medicaid, and 3) elucidate approaches and strategies used by high- vs. low-value practices. A comprehensive evaluation
and analysis of variation in spending, utilization, and quality of radiation oncology practices is the first step to optimizing
cancer care delivery with radiation treatments across the U.S. Identifying the differences in approaches to care and
barriers encountered by high- vs low-value practices are critically important for physicians, patients, hospital leaders, and
policymakers. While the current mandatory Radiation Oncology Alternative Payment Model (RO APM) by Centers for
Medicare and Medicaid (CMS) is on hold, alternative payment and delivery models are impacting oncology. This project
will be timely and provide CMS and practices with valuable data to adjust or inform any future APMs in the future, as
necessary to ensure successful transition without negatively impacting the quality of cancer care. Even if the current form
of the RO APM is not implemented at this time, understanding variation in high- and low-value practices will still be
valuable to determine whether certain practices need additional support to continue to provide high-value care for their
cancer patients.
In Aim 1 of the proposed study, the investigator will analyze Medicare claims data to characterize the variation in
spending, utilization, and quality for patients undergoing radiation therapy for cancer treatments. She will systematically
and comprehensively evaluate radiation oncology practices. In Aim 2, she will delve into whether there are differences in
spending, utilization, and quality for dual-eligible patients. Finally, in Aim 3, she will perform key informant interviews
of high- and low-value practices to elucidate differences in management, leadership, and care delivery.

## Key facts

- **NIH application ID:** 10830478
- **Project number:** 5K08CA273549-02
- **Recipient organization:** BRIGHAM AND WOMEN'S HOSPITAL
- **Principal Investigator:** Miranda Lam
- **Activity code:** K08 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $270,369
- **Award type:** 5
- **Project period:** 2023-05-01 → 2027-04-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10830478

## Citation

> US National Institutes of Health, RePORTER application 10830478, Assessing Variation in Outcomes for Cancer Patients Receiving Radiation Treatments and Identifying High-Value Radiation Oncology Practices (5K08CA273549-02). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10830478. Licensed CC0.

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