Introduction: Genesis Healthcare Partners (GHP), a large urology group in Southern California, together with the Prostate Cancer Active Surveillance Project (PCASP) and UnitedHealthcare (UHC) developed a Pay-for-Performance (P4P) demonstration project to enhance the uptake of conservative management (active surveillance [AS], watchful waiting [WW]) for men with low-risk prostate cancer (LRPCa) and leverage the Electronic Medical Record (EMR) to obtain granular, high fidelity data. Methods: Four evidence-based quality measures and their respective thresholds were developed:1. completion of an EMR embedded template documenting both risk and management (90% threshold), 2. adoption of AS/WW for LRPCa (75% threshold), 3. 2 PSA tests/year for AS (75% threshold), 4. confirmatory biopsy within 18 months of the diagnostic biopsy (75% threshold). Structured templates were embedded into the Allscripts EMR. Data were electronically queried from the structured templates using Microsoft Access and analyzed and reported in Microsoft Excel . Biannual PSA data and evidence of a confirmatory biopsy will be reported on an annual basis. Data are presented from inception of the project on January 1st, 2022 through September 30th, 2022. Results: For the first three quarters of the study, January through September 2022, there was a progressive increasing trend in template completion; Q1 71/107 (67%), Q2 97/137 (73%), Q3 67/80 (86%). Table 1 includes PCa risk levels and management selection for men with newly diagnosed PCa during the period of study. Conclusions: This P4P project is a novel approach to enhancing the uptake of AS for men with LRPCa. Implementation of the P4P intervention via EMR embedded templates demonstrates the potential to leverage the EMR and obtain granular data including patient risk stratification and management selection. Early results indicate excellent physician participation and improved AS uptake (76%) for patients with LRPCa compared to national trends. SOURCE OF Funding: None
