# Project 3: Care Integration for Patients with Cancer Receiving Post-Acute Care and Hospice

> **NIH NIH P01** · HARVARD MEDICAL SCHOOL · 2024 · $310,666

## Abstract

PROJECT SUMMARY/ABSTRACT: Project 3 - Care Integration for Patients Receiving Post-Acute Care
and Hospice
This Project focuses on care integration for patients with cancer who are treated in post-acute (skilled nursing
facilities, inpatient rehabilitation facilities, and home health) and hospice settings. Care for patients with cancer
at the end-of-life is often fragmented and not patient-centered, particularly among marginalized populations.
Less is known about the coordination and quality of post-acute care for patients undergoing complex cancer
surgeries and hospitalizations for disease- and treatment-related complications. There has been substantial
consolidation in post-acute care and hospice settings, including a marked increase in the prevalence of for-
profit chains. Structural integration across sectors (e.g., with systems/hospitals) could increase other forms of
integration, such as: functional (e.g., policies and protocols for coordination of care across settings), normative
(e.g., common culture), interpersonal (e.g., collaboration and teamwork within and across organizations), and
clinical process integration (e.g., activities integrating services across settings). Alternatively, such structural
integration could increase incentives for referrals to lower-quality facilities, service or staffing reductions, or
employment of less skilled clinical staff. Working with Projects 1, 2, and 4 and the Cores, the team will conduct
case studies and interviews of clinicians within health systems and their hospitals and practices as well as
clinicians and staff in post-acute care and hospice settings to evaluate how structural features (e.g. co-location,
referral patterns, geographic reach) relate to these other non-structural forms of integration. The team will
survey medical and nursing directors, clinicians, and staff from a random sample of post-acute and hospice
facilities that do not have ownership arrangements with health systems to measure non-structural forms of
integration outside of health systems. The team will use administrative data from Medicare, Medicaid, and
commercial insurers to describe key outcomes, such as utilization (e.g. readmissions), spending, and high
quality and equitable care (e.g., post-operative complications, patient/family experiences), and to examine
associations between integration types and outcomes overall and for marginalized populations. The aims are:
Aim 1: Adapt an existing framework to describe key forms of integration (i.e., structural, functional, normative,
interpersonal, and process) for the care of oncology patients in post-acute care and hospice settings and
identify mechanisms through which forms of care integration may produce improved outcomes and more
equitable care for patients using post-acute and hospice care. Aim 2: Measure care integration in post-acute
care and hospice settings and assess relationships among different forms of care integration. Determine how
these relationships vary by ag...

## Key facts

- **NIH application ID:** 10935523
- **Project number:** 1P01CA281850-01A1
- **Recipient organization:** HARVARD MEDICAL SCHOOL
- **Principal Investigator:** Mary Beth Landrum
- **Activity code:** P01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $310,666
- **Award type:** 1
- **Project period:** 2024-09-15 → 2029-08-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10935523

## Citation

> US National Institutes of Health, RePORTER application 10935523, Project 3: Care Integration for Patients with Cancer Receiving Post-Acute Care and Hospice (1P01CA281850-01A1). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10935523. Licensed CC0.

---

*[NIH grants dataset](/datasets/nih-grants) · CC0 1.0*