Nancy L. Keating
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View article: Subspecialization of Surgical Specialties in the US
Subspecialization of Surgical Specialties in the US Open
Importance Subspecialists—physicians with narrower clinical focus—play an increasing role in US health care, particularly in surgery, where most trainees now pursue fellowship training. Yet little is known about the degree of subspecializa…
View article: Smartphone-Based Measures as Indicators of Functional Status in Patients With Advanced Cancer
Smartphone-Based Measures as Indicators of Functional Status in Patients With Advanced Cancer Open
This cohort study examines whether digital measures collected from smartphones could enable the remote monitoring of functional status and quality of life among patients with advanced cancer.
View article: Practice-Level Spending Variation for Radiation Treatment Episodes Among Older Adults With Cancer
Practice-Level Spending Variation for Radiation Treatment Episodes Among Older Adults With Cancer Open
Importance Radiation treatments are an essential but expensive component of cancer care. Objective To elucidate trends in radiation spending and identify factors associated with practice-level variations across the US health care system to…
View article: The Role of Regional and Practice Trial Sites in Distorted Randomized Cancer Trial Enrollment
The Role of Regional and Practice Trial Sites in Distorted Randomized Cancer Trial Enrollment Open
Representative trials are critical to advancing cancer treatment, yet little is known about how geographic siting contributes to non-representative enrollment. Using patient-level data, we determined how the choice of trial-enrolling regio…
View article: Smartphone-based measures as real-world indicators of functional status in advanced cancer patients
Smartphone-based measures as real-world indicators of functional status in advanced cancer patients Open
Objective This study evaluated the feasibility of using smartphone-based metrics to monitor physical functioning and quality of life in patients with advanced gynecological cancers. We analyzed associations between gait (step count, cadenc…
View article: The association of travel distance and other patient characteristics with breast cancer stage at diagnosis and treatment completion at a rural Rwandan cancer facility
The association of travel distance and other patient characteristics with breast cancer stage at diagnosis and treatment completion at a rural Rwandan cancer facility Open
View article: Racial discrimination among women seeking breast cancer care
Racial discrimination among women seeking breast cancer care Open
Discrimination can contribute to worse health outcomes, but its prevalence in breast cancer is not well studied. We aimed to understand how women with stage I-III breast cancer faced discrimination in health care and everyday settings thro…
View article: Use of and Steering to Pharmacies Owned by Insurers and Pharmacy Benefit Managers in Medicare
Use of and Steering to Pharmacies Owned by Insurers and Pharmacy Benefit Managers in Medicare Open
Importance The prevalence of pharmacies owned by integrated insurers and pharmacy benefit managers (PBMs), or insurer-PBMs, is of growing regulatory concern. However, little is known about the role of these pharmacies in Medicare, in which…
View article: Outpatient palliative care and end-of-life care intensity: linking Massachusetts Cancer Registry with All-Payer Claims Database
Outpatient palliative care and end-of-life care intensity: linking Massachusetts Cancer Registry with All-Payer Claims Database Open
Background Early palliative care is associated with better outcomes for patients with advanced-stage cancers. Using a novel data linkage, we assessed outpatient palliative care use before death and its association with end-of-life care int…
View article: The Promise and Perils of Oncology Care in Medicare Advantage
The Promise and Perils of Oncology Care in Medicare Advantage Open
View article: See Me, Hear Me: Racial Discrimination Among Women Seeking Breast Cancer Care
See Me, Hear Me: Racial Discrimination Among Women Seeking Breast Cancer Care Open
View article: Estimating oncologist variability in prescribing systemic cancer therapies to patients in the last 30 days of life
Estimating oncologist variability in prescribing systemic cancer therapies to patients in the last 30 days of life Open
Introduction Clinical guidelines and quality improvement initiatives have identified reducing the use of end‐of‐life cancer therapies as an opportunity to improve care. We examined the extent to which oncologists differed in prescribing sy…
View article: Developing national cancer survivorship standards to inform quality of care in the United States using a consensus approach
Developing national cancer survivorship standards to inform quality of care in the United States using a consensus approach Open
Purpose To develop United States (US) standards for survivorship care that informs (1) essential health system policy and process components and (2) evaluation of the quality of survivorship care. Methods The National Cancer Institute and …
View article: New Recommendations for Breast Cancer Screening—In Pursuit of Health Equity
New Recommendations for Breast Cancer Screening—In Pursuit of Health Equity Open
US Preventive Services Task Force; Wanda K. Nicholson, MD, MPH, MBA; Michael Silverstein, MD, MPH; John B. Wong, MD; Michael J. Barry, MD; David Chelmow, MD; Tumaini Rucker Coker, MD, MBA; Esa M. Davis, MD, MPH; Carlos Roberto Jaén, MD, Ph…
View article: Trends in Integration Between Physician Organizations and Pharmacies for Self-Administered Drugs
Trends in Integration Between Physician Organizations and Pharmacies for Self-Administered Drugs Open
Importance Increasing integration across medical services may have important implications for health care quality and spending. One major but poorly understood dimension of integration is between physician organizations and pharmacies for …
View article: Prior Authorization and Association With Delayed or Discontinued Prescription Fills
Prior Authorization and Association With Delayed or Discontinued Prescription Fills Open
PURPOSE Prior authorization requirements are increasing but little is known about their effects on access to care. We examined the association of a new prior authorization policy with delayed or discontinued prescription fills for oral ant…
View article: Open-Source, Step-Counting Algorithm for Smartphone Data Collected in Clinical and Nonclinical Settings: Algorithm Development and Validation Study
Open-Source, Step-Counting Algorithm for Smartphone Data Collected in Clinical and Nonclinical Settings: Algorithm Development and Validation Study Open
Background Step counts are increasingly used in public health and clinical research to assess well-being, lifestyle, and health status. However, estimating step counts using commercial activity trackers has several limitations, including a…
View article: An essential goal within reach: attaining diversity, equity, and inclusion for the <i>Journal of the National Cancer Institute</i> journals
An essential goal within reach: attaining diversity, equity, and inclusion for the <i>Journal of the National Cancer Institute</i> journals Open
View article: Opportunities for Savings in Risk Arrangements for Oncologic Care
Opportunities for Savings in Risk Arrangements for Oncologic Care Open
Importance As the US accelerates adoption of alternative payment through global payment models such as Accountable Care Organizations (ACOs) or Medicare Advantage (MA), high spending for cancer care is a potential target for savings. Objec…
View article: Quality of Medication Cost Conversations and Interest in Future Cost Conversations Among Older Adults
Quality of Medication Cost Conversations and Interest in Future Cost Conversations Among Older Adults Open
View article: Designing a Digital Tool to Inform Oncology Practices About Cancer Treatment Cost Burdens
Designing a Digital Tool to Inform Oncology Practices About Cancer Treatment Cost Burdens Open
Paper describes our development of a web-based tool to make Medicare patient prices for cancer drugs known to their care teams.
View article: An essential goal within reach: attaining diversity, equity, and inclusion for the <i>Journal of the National Cancer Institute</i> journals
An essential goal within reach: attaining diversity, equity, and inclusion for the <i>Journal of the National Cancer Institute</i> journals Open
View article: Utilization Management Trends in Medicare Part D Oncology Drugs, 2010-2020
Utilization Management Trends in Medicare Part D Oncology Drugs, 2010-2020 Open
This study examines the exposure of Medicare Part D beneficiaries to utilization management, such as prior authorization, for oral oncology drugs.
View article: Medicare’s Plan for Drug-Price Negotiation — The Importance of Defining Generic Entry
Medicare’s Plan for Drug-Price Negotiation — The Importance of Defining Generic Entry Open
The Inflation Reduction Act allows CMS to negotiate prices for a small number of Medicare-covered drugs. Identifying opportunities to proactively address potential gaming of this authority is important.
View article: Implementation research: including breast examinations in a cervical cancer screening programme, Rwanda
Implementation research: including breast examinations in a cervical cancer screening programme, Rwanda Open
In the short-term, integrating clinical breast examination with cervical cancer screening was not associated with detection of early-stage breast cancer among asymptomatic women. Priority should be given to encouraging women to seek timely…
View article: Transforming Specialty Care Delivery and Payment Under Global Budgets—Insights from the Provision of Surgical Services in Maryland
Transforming Specialty Care Delivery and Payment Under Global Budgets—Insights from the Provision of Surgical Services in Maryland Open
This Viewpoint discusses Maryland’s global budget revenue model, which centrally regulates reimbursement rates for all payers via a hospital-specific, prospectively set cap on total annual revenue across all care sites.
View article: Organization of Cancer Specialists in US Physician Practices and Health Systems
Organization of Cancer Specialists in US Physician Practices and Health Systems Open
PURPOSE To describe the supply of cancer specialists, the organization of cancer care within versus outside of health systems, and the distance to multispecialty cancer centers. METHODS Using the 2018 Health Systems and Provider Database f…
View article: Cost-Related Medication Nonadherence and Desire for Medication Cost Information Among Adults Aged 65 Years and Older in the US in 2022
Cost-Related Medication Nonadherence and Desire for Medication Cost Information Among Adults Aged 65 Years and Older in the US in 2022 Open
Importance Rising prescription drug costs and increasing prices for consumer goods may increase cost-related medication nonadherence. Cost-conscious prescribing can be supported by real-time benefit tools, but patient views on real-time be…
View article: Breast cancer treatment receipt and the role of financial stress, health literacy, and numeracy among diverse breast cancer survivors
Breast cancer treatment receipt and the role of financial stress, health literacy, and numeracy among diverse breast cancer survivors Open
View article: Practice-Level Variation in Molecular Testing and Use of Targeted Therapy for Patients With Non–Small Cell Lung Cancer and Colorectal Cancer
Practice-Level Variation in Molecular Testing and Use of Targeted Therapy for Patients With Non–Small Cell Lung Cancer and Colorectal Cancer Open
Importance All patients with newly diagnosed non–small cell lung cancer (NSCLC) and colorectal cancer (CRC) should receive molecular testing to identify those who can benefit from targeted therapies. However, many patients do not receive r…