Nicole Mott, MD, MSCR

Fellow

Dr. Mott has completed two clinical years of general surgery training at the University of Colorado, and she is currently completing a health services research and health policy fellowship through the National Clinician Scholars Program (NCSP) at the University of Michigan. Nicole is thrilled to have the opportunity to join the Costs of Care team as a fellow and to advance the Costs of Care mission of creating a more affordable and equitable healthcare system.

I have completed two clinical years of general surgery training at the University of Colorado, and I am currently completing a health services research and health policy fellowship through the National Clinician Scholars Program (NCSP) at the University of Michigan. I am thrilled to have the opportunity to join the Costs of Care team as a fellow and to advance the Costs of Care mission of creating a more affordable and equitable healthcare system.

Throughout my clinical training, I have grown frustrated that despite excessive healthcare spending, the United States falls short in many measures of healthcare quality, patient-centeredness, and equity. The goal of my work thus far has been to reduce healthcare costs and increase value by de-implementing or reducing low-value care.1–15 I have been drawn to explore this challenge particularly within the field of surgical oncology, in which I’ve observed patients facing the psychological impact of a cancer diagnosis searching for “peace of mind” and driven to “fight” and clinicians wanting to provide reassurance and exhaust all possible treatment options. I have investigated factors that influence patients’ and clinicians’ desire for more versus less medical care with the hopes of addressing these factors in a patient-centered way to resolve inherent tensions in de-implementation.

However, decreasing waste is only part of addressing healthcare costs and improving value in the healthcare system, as patients, particularly vulnerable populations, are at risk for significant financial burden associated with routine and necessary medical care. Therefore, my academic interests also include exploring how insurance design, including value-based insurance and high-deductible insurance plans, impact financial toxicity for patients with cancer needing surgery.

As a Costs of Care Fellow, I look forward to working with thought leaders and putting scholarship into action through advocacy, policy change, dissemination, and implementation to improve the value and affordability of healthcare across the U.S. on a system-wide level and on an individual level with each patient I have the privlege to care for.

Outside of my clinical and academic interests, I enjoy exploring the outdoor activities Colorado has to offer including hiking and snowboarding, though I am a Michigander at heart!

Selected Publications:

  1. Mott NM, Chaitoff AM, Kullgren JT. The Need for More Effective Tools to Decrease Use of Low-Value Care. JAMA Netw Open. 2024;7(11):e2442301. doi:10.1001/jamanetworkopen.2024.42301
  2. Mott NM, Dossett LA. Opportunities and Challenges of Defining “Value” in Oncology Care. Ann Surg Oncol. 2022;29(11):6518-6519. doi:10.1245/s10434-022-11548-7
  3. Wang T, Mott N, Miller J, et al. Patient Perspectives on Treatment Options for Older Women With Hormone Receptor–Positive Breast Cancer: A Qualitative Study. JAMA Netw Open. 2020;3(9):e2017129. doi:10.1001/jamanetworkopen.2020.17129
  4. Mott N, Wang T, Miller J, et al. Medical Maximizing–Minimizing Preferences in Relation to Low-Value Services for Older Women with Hormone Receptor-Positive Breast Cancer: A Qualitative Study. Ann Surg Oncol. 2021;28(2):941-949. doi:10.1245/s10434-020-08924-6
  5. Mott N, Dossett LA. ASO Author Reflections: Can Medical Maximizing–Minimizing Preferences Inform De-implementation Efforts for Low-Value Breast Cancer Services in Older Women? Ann Surg Oncol. 2020;27(S3):884-885. doi:10.1245/s10434-020-09009-0
  6. Mott NM, Markovitz NH, Wang T, et al. Avoiding Overtreatment of Women ≥70 With Early-Stage Breast Cancer: A Provider-Level Deimplementation Strategy. J Surg Res. 2023;284:124-130. doi:10.1016/j.jss.2022.11.072
  7. Dossett LA, Mott NM, Bredbeck BC, et al. Using Tailored Messages to Target Overuse of Low-Value Breast Cancer Care in Older Women. J Surg Res. 2022;270:503-512. doi:10.1016/j.jss.2021.10.005
  8. Baskin AS, Wang T, Mott NM, Hawley ST, Jagsi R, Dossett LA. Gaps in Online Breast Cancer Treatment Information for Older Women. Ann Surg Oncol. 2021;28(2):950-957. doi:10.1245/s10434-020-08961-1
  9. Bredbeck BC, Baskin AS, Wang T, et al. Incremental Spending Associated with Low-Value Treatments in Older Women with Breast Cancer. Ann Surg Oncol. 2022;29(2):1051-1059. doi:10.1245/s10434-021-10807-3
  10. Bredbeck BC, Mott NM, Wang T, et al. Facility-Level Variation of Low-Value Breast Cancer Treatments in Older Women with Early-Stage Breast Cancer: Analysis of a Statewide Claims Registry. Ann Surg Oncol. 2022;29(7):4155-4164. doi:10.1245/s10434-022-11631-z
  11. Leonard LD, De Araujo TB, Quinn C, et al. De-implementation of Axillary Dissection in Women Undergoing Mastectomy for Breast Cancer. Ann Surg Oncol. 2023;30(9):5692-5702. doi:10.1245/s10434-023-13698-8
  12. Ellsworth BL, Metz AK, Mott NM, et al. Review of Cancer-Specific Quality Measures Promoting the Avoidance of Low-Value Care. Ann Surg Oncol. 2022;29(6):3750-3762. doi:10.1245/s10434-021-11303-4
  13. Mott NM, Mierzwa ML, Casper KA, et al. Financial Hardship in Patients With Head and Neck Cancer. JCO Oncol Pract. 2022;18(6):e925-e937. doi:10.1200/OP.21.00683
  14. Chen MM, Mott NM, Miller J, et al. Clinician Attitudes and Beliefs About Deintensifying Head and Neck Cancer Surveillance. JAMA Otolaryngol Neck Surg. 2022;148(1):43. doi:10.1001/jamaoto.2021.2824
  15. Stuart CM, Bronsert MR, Meguid RA, et al. The deimplementation of laboratory testing in low-risk patients as recommended by the American society of anesthesiologists: An ACS-NSQIP longitudinal analysis. World J Surg. 2024;48(5):1014-1024. doi:10.1002/wjs.12154