HealthDay News — According to a study published in JAMA Oncology, a bundled-payment program is associated with better adherence to quality indicators and better outcomes over time when compared with a fee-for-service (FFS) program in breast cancer care.

CJ Wang, MD, from Koo Foundation Sun Yat-Sen Cancer Center in Taipei, Taiwan, and colleagues examined the correlation of outcomes and medical expenditures with a bundled payment pay-for-performance program versus a FFS program in Taiwan. 

Women with newly diagnosed breast cancer were followed for 5 years, with a final sample of propensity score-matched patients comprising 4485 in the bundled-payment group and 13,455 in the FFS group.

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The researchers found that 34.9% of patients with applicable quality indicators had full adherence to quality indicators, compared with 27.5% with applicable quality indicators in the FFS group (P<.001). For patients with stages 0 to 3 breast cancer, the 5-year event-free survival rates were 84.48 and 80.88% for the bundled-payment and FFS groups, respectively (P<.01).

The 5-year medical payments of the bundled-payment group remained stable, while there was an increase in the FFS group from $16,000 to $19,230; starting in 2008, payments for the FFS group exceeded bundled payments.

“In Taiwan, compared with the regular FFS program, bundled payment may lead to better adherence to quality indicators, better outcomes, and more effective cost-control over time,” the authors write.


Wang CJ, Cheng SH, Wu J, Lin Y, Kao W, Lin C, Chen Y, Tsai S, Kao F, Huang AT. Association of a Bundled-Payment Program With Cost and Outcomes in Full-Cycle Breast Cancer Care. JAMA Oncol. Published online October 20, 2016. doi:10.1001/jamaoncol.2016.4549

Newcomer LN. Better Outcomes for Lower Costs in Breast Cancer CareFinding a Way. JAMA Oncol.Published online October 20, 2016. doi:10.1001/jamaoncol.2016.4544

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