# Project 2: Care Integration for Patients with Cancer Treated in Independent Practices

> **NIH NIH P01** · HARVARD MEDICAL SCHOOL · 2024 · $450,602

## Abstract

PROJECT SUMMARY/ABSTRACT: Project 2 - Care Integration for Patients with Cancer Treated in
Independent Practices
The goal of this Project is to describe care integration for patients with cancer treated in independent oncology
practices and to identify forms of care integration associated with better quality and outcomes. Many cancer
patients are treated by medical oncologists in independent practices. Their clinicians must deliver high-quality
care while also coordinating care across different types of clinicians (e.g., surgeon, radiation oncologist,
pharmacists) and multiple settings (e.g., office, pharmacy, hospital, post-acute care and hospice). Medical
oncologists have key roles in patients’ initial evaluation, treatment initiation, coordination of multidisciplinary
treatment, survivorship care, and palliative and end-of-life care. Project 2 will describe key forms of care
integration for medical oncology practices (structural, normative, functional, interpersonal, and process) and
assess relationships of different forms of integration with one another (e.g., extent of structural integration with
strength of interpersonal integration) and with outcomes demonstrating integrated care for patients. Working
with Projects 1, 2, and 4 and the Cores, the team will conduct case studies to learn about mechanisms by
which independent oncology practices achieve care integration and to adapt and tailor measures of integration
to oncology care. The team will survey practice leaders, managers, clinicians, staff, and patients from a
representative sample of independent practices to measure various forms of integration. Using administrative
data from Medicare, Medicaid, and commercial insurers, the team will measure key outcomes (including quality
of care, utilization, and spending) and examine relationships between these outcomes and various forms of
integration. At each step in the investigation, we examine how integration relates to care delivery and
outcomes for historically marginalized subgroups. Project 2 aims mirror the overall Project aims:
Aim 1: Adapt an existing framework and measurement concepts to describe key forms of integration beyond
structural (i.e., functional, normative, interpersonal, process) for oncology care delivered in independent
oncology practices using case studies and interviews. Identify mechanisms through which forms of integration
may yield improved and more equitable patient care and better outcomes.
Aim 2: Measure care integration in independent practices and assess relationships among different forms of
care integration. Determine how and whether these relationships vary by practice and market factors.
Aim 3. Assess the association of each form of integration with utilization, spending, and high-quality and
equitable care delivered in independent oncology practices and assess mechanisms through which integration
improves or worsens overall outcomes and equitable care for marginalized subgroups.
Defining and assessing how...

## Key facts

- **NIH application ID:** 10935522
- **Project number:** 1P01CA281850-01A1
- **Recipient organization:** HARVARD MEDICAL SCHOOL
- **Principal Investigator:** Nancy L Keating
- **Activity code:** P01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $450,602
- **Award type:** 1
- **Project period:** 2024-09-15 → 2029-08-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10935522

## Citation

> US National Institutes of Health, RePORTER application 10935522, Project 2: Care Integration for Patients with Cancer Treated in Independent Practices (1P01CA281850-01A1). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10935522. Licensed CC0.

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