# Impact of urologist practice organization and health policy on prostate cancer treatment, overtreatment and spending

> **NIH AHRQ R01** · UNIVERSITY OF MICHIGAN AT ANN ARBOR · 2020 · $327,954

## Abstract

Project Summary and Relevance
Many men diagnosed with prostate cancer will not die of it even without any intervention,
enhancing the possibility of overtreatment. How urologists organize themselves is strongly
linked to the nature and extent of treatment for localized prostate cancer. Those practicing in
large urology groups, particularly urologists with an ownership stake in radiation facilities, more
commonly treat men with prostate cancer who are unlikely to benefit (i.e., overtreatment).
Conversely, urologists in multispecialty groups provide care at a lower cost, without
compromising quality.
Uncertainty surrounding the implications of evolving health policy is prompting a sea change in
how physicians align themselves. Faced with increasing administrative burden to navigate
reforms, urologists practicing alone or in small groups are aligning themselves with larger
entities, including multispecialty groups and large urology groups. Because practice context is
strongly tied to prostate cancer overtreatment and spending, policy induced realignment of
urologists has significant public health implications. The goal of this national study is to
understand the effects of policy on relationships between urologist practice organization and
prostate cancer care (i.e., treatment, quality and payment). This grant, which uses national
Medicare data, has the following three aims: 1) To determine the effect of changing practice
organization on prostate cancer care; 2) To measure the effect of hospital ownership of urology
practices on prostate cancer care; and, 3) To determine how policy impacts relationships
between urologist practice organization and prostate cancer care. We plan to use interrupted
time series and difference-in-difference methods to control for differences in baseline case-mix
and temporal trends.
Results from this study have real-world implications for patients, who are naturally interested in
getting the best prostate cancer care at the lowest possible cost. Our findings will immediately
inform policymakers on the extent to which the impact of policy is mediated by practice
organization, particularly by those that have historically favored volume over value.

## Key facts

- **NIH application ID:** 9985012
- **Project number:** 5R01HS025707-04
- **Recipient organization:** UNIVERSITY OF MICHIGAN AT ANN ARBOR
- **Principal Investigator:** BRENT K. HOLLENBECK
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** AHRQ
- **Fiscal year:** 2020
- **Award amount:** $327,954
- **Award type:** 5
- **Project period:** 2017-09-30 → 2022-07-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9985012

## Citation

> US National Institutes of Health, RePORTER application 9985012, Impact of urologist practice organization and health policy on prostate cancer treatment, overtreatment and spending (5R01HS025707-04). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/9985012. Licensed CC0.

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