Telephonic Advance Care Planning (acp) with Medicare Patients with Advanced Cancer: Interim Program Results.

e17712 Background: Patient-provider discussion of future healthcare decisions in accordance with patient values—ACP—is especially relevant for metastatic cancer patients. Extending survival is the primary goal, but maximizing quality of life, including avoiding hospitalizations, is also essential. Innovent is an oncology disease management program which includes ACP counseling by a trained nurse. We measured hospitalizations, hospice use, chemotherapy within 14 days of death and total claims cost for patients who had died by the midpoint of the 3-year program. Methods: Aetna Medicare patients with metastatic cancer treated at Texas Oncology and managed by Innovent from 6/1/2013 to 9/30/2014 were eligible (n = 231); of these, n = 50 had EMR-documented dates of death as of 12/31/2014. All patients were offered all Innovent services, including ACP counseling, which they could accept or decline. We divided non-survivors into 2 cohorts: participated in ACP; did not participate (No ACP). Characteristics and outcomes were obtained from claims and EMR data and compared by Chi-Square and Wilcoxon Rank Sum tests (α = .05). Results: Karnofsky Performance Score at intake was higher for ACP (p = .05); other characteristics did not differ. Results are listed in the table. Non-significant trends favor ACP vs. no ACP; enrollment is ongoing. Conclusions: ACP addresses patient wishes involving end of life care. Our interim results suggest that when ACP counseling takes place early in the continuum of advanced cancer for those who ultimately die of their disease, outcomes related to quality of life appear to be enhanced and there is a trend towards lower claims cost. No ACP Had ACP Counseling (n = 31) (n = 19) p-value (No., % of total) or (Median [Min, Max]) Entered hospice 10, 32.3% 7, 36.8% 0.740 Days in Hospice 9.5 [3, 89] 9.0 [2, 69] 0.769 Ever admitted 27, 87.1% 13, 68.4% 0.109 Average Length of Stay 4.7 [0, 24] 2.0 [0, 16] 0.185 Chemo w/in 14 days of death 6, 19.4% 2, 10.5% 0.409 Died in Hospital 7, 26.9% 3, 21.4% 1.000 Total Claims Cost $38,658 [$7,124, $118,200] $32,505 [$4,551, $124,825] 0.6173