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UNCOVER-PC: Uniting Novel Concepts of Value to Enhance Reform in Palliative Care

Award Number: R37CA307515
ORGANIZATION: NATIONAL CANCER INSTITUTE
OPDIV: NIH
AWARD CLASS: DISCRETIONARY
AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)
PERIOD OF PERFORMANCE START DATE: 08/13/2026
PERIOD OF PERFORMANCE END DATE: 07/31/2031

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UNCOVER-PC: Uniting Novel Concepts of Value to Enhance Reform in Palliative Care - Abstract More than 600,000 people with cancer die in the US annually. Many experience avoidable suffering and poor quality of life (QoL) due to inadequate symptom management. Early outpatient specialty palliative care (PC) has demonstrated benefits on QoL and end-of-life (EOL) outcomes in clinical trials as early as 2010, leading national guidelines to recommend initiation early after advanced cancer diagnosis. However, real-world delivery of outpatient specialty PC varies widely across different modalities, including timing, visit frequency, duration, and delivery approach, which creates uncertainty about what constitutes the most effective modality and which patient subgroups derive the greatest benefit. Compounding this challenge is persistently low uptake: in 2019, only 10% of patients received specialty PC within 3 months of an advanced cancer diagnosis. This underuse reflects patient- and provider-level barriers and systemic misalignment between reimbursement structures and the proven value of specialty PC. To address these systemic challenges and inform the design and evaluation of VBID strategies, we will conduct a patient-centered value assessment to inform value-based insurance design (VBID) models for outpatient specialty PC. Our value assessment framework incorporates novel value elements, including (1) family spillover effects that PC support improves QoL and reduces caregiving burden for caregivers, (2) heterogeneity of PC benefits across modalities and patient sociodemographic and clinical characteristics, (3) severity-adjusted valuation that allows a higher willingnessto-pay for PC with more severe illness, and (4) insurance value through covering direct medical costs of health care interventions to provide physical and financial risk protection for individuals. We will focus on Medicare beneficiaries with advanced breast, colorectal, and lung cancers, integrating data sources from populationbased cancer registries, Medicare claims, national surveys, and randomized controlled trials to evaluate the health and economic impacts of different PC modalities. Aim 1 will use a retrospective cohort analysis to assess associations between various PC modalities and health outcomes including EOL care and costs, and identify patient subgroups that derive the highest benefit from different PC modalities. Aim 2 will develop a discrete-time state-transition microsimulation model to estimate long-term societal costs and cost-effectiveness of various PC modalities, including both costs and QoL for patients and families. In Aim 3, we will simulate alternative VBID payment strategies to modify patient cost-sharing and provider reimbursements. We will project their impact on PC utilization and health and economic outcomes. By identifying which PC modality, for whom, and under what payment structures outpatient specialty PC delivers the most value, this study will generate evidence to advance efficient and effective outpatient specialty PC delivery and improve health outcomes for patients with advanced cancers and their families.


Issue Date FY	Funding FY	Legal Entity Name	Legal Entity Address	Legal Entity City	Legal Entity State	Legal Entity Zip Code	Legal Entity COUNTY	Legal Entity COUNTRY	Assistance Listing	Award Code	Budget Year	Action Date	Action Type	Action Amount

Issue Date FY: 2026 ( Subtotal = $682,730 )
2026	2026	EMORY UNIVERSITY	201 DOWMAN DR NE	ATLANTA	GA	30322	DEKALB	USA	Cancer Cause and Prevention Research	000	1	8/12/2026	NEW	$682,730
														Subtotal = $682,730

Grand Total All Awards = $682,730

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UNCOVER-PC: Uniting Novel Concepts of Value to Enhance Reform in Palliative Care

Award Number: R37CA307515

ORGANIZATION: NATIONAL CANCER INSTITUTE

OPDIV: NIH

AWARD CLASS: DISCRETIONARY

AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)

PERIOD OF PERFORMANCE START DATE: 08/13/2026

PERIOD OF PERFORMANCE END DATE: 07/31/2031

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