About

Vishnukamal Golla is a Medical Assistant Professor in the Department of Urology at Duke University and a Core Faculty Member at the Duke-Margolis Institute for Health Policy. His role involves both clinical and academic responsibilities within the department, contributing to education, research, and patient care in urology. Specific details about his research focus, background, or key contributions are not provided on the page.

Research topics

• Medicine
• Internal medicine
• Oncology
• Nursing
• Anesthesia
• Pharmacology
• Urology
• Family medicine
• Medical emergency
• Finance
• Emergency medicine
• Intensive care medicine

Selected publications

• Payment Bundles for Prostatectomy: A New Way to Improve Value for Prostate Cancer Care

  Urology · 2025-03-22 · 1 citations

  review
  PublisherDOI

• Design of Payment and Reimbursement Strategies for Focal Therapy for Acceptance in Value-Based Care Models

  2024-01-01

  book-chapterSenior author
  PublisherDOI

• Long-Term Trends in Decisional Regret Among Men with Localized Prostate Cancer

  JU Open Plus · 2024-04-01 · 3 citations

  articleOpen access

  Purpose: There are several evidence-based treatment options for localized prostate cancer (PCa). Decisional regret (DR), or regret based on the treatment a patient chooses, is poorly understood in patients with PCa. We describe long-term trends in DR for patients with localized PCa and factors associated with regret. Materials and Methods: We surveyed an established prospective cohort of patients with PCa in North Carolina who were diagnosed between 2011 and 2013. DR was assessed by a validated instrument at 12, 24, 36, 48, 60, 72, 84, and 120 months after treatment or active surveillance (AS). We estimated the overall trend of DR and examined how DR was associated with treatment and demographic data using generalized linear mixed-model regressions. Results: The sample included 1456 men. At 12 months, 88% (n = 1100) of patients did not regret their treatment. With all time points included, DR increased slightly in early months and the speed of increase slowed over time ( P = .003 for time, .02 for time-squared). Divorced men were more likely to have DR compared with married men (odds ratio [OR] = 1.5; 95% confidence interval [CI] 0.9-2.7). African Americans (OR = 1.5; 95% CI 1.0-2.1) and those who underwent surgery had significantly more regret (14.6%; 95% CI 11.3-18.0, P = .01) than patients of other racial groups or who underwent AS, respectively. Conclusions: Although DR is low overall in this cohort, being married and AS were associated with lower regret than those who were not married or who underwent surgery, respectively. Understanding factors that affect DR can guide urologists to more effectively direct resources and counseling.

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• MP48-03 QUALITY MEASURES REPORTED BY UROLOGISTS IN THE MERIT-BASED INCENTIVE PAYMENT SYSTEM

  The Journal of Urology · 2023-03-23

  articleSenior author

  You have accessJournal of UrologyCME1 Apr 2023MP48-03 QUALITY MEASURES REPORTED BY UROLOGISTS IN THE MERIT-BASED INCENTIVE PAYMENT SYSTEM Avinash Maganty, Noah Krampe, Anup Shah, and Vishnukamal Golla Avinash MagantyAvinash Maganty More articles by this author , Noah KrampeNoah Krampe More articles by this author , Anup ShahAnup Shah More articles by this author , and Vishnukamal GollaVishnukamal Golla More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003294.03AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: The majority of urologists are required to participate in merit-based incentive payment system (MIPS) –a Medicare-mandate reporting system in which physicians must track and report quality measures. Medicare adjusts physician reimbursement based on performance across these measures, with the intention to improve the quality of patient care. However, very few MIPS measures are relevant to urology patients and it is unclear what measures urologists are choosing to track and report. METHODS: We performed a cross-sectional analysis of MIPS measures reported by urologists for the most recent performance year. Urologists were categorized by their reporting affiliation (i.e., individual, group, or alternative payment model [APM]). We identified the measures which were most frequently reported by urologists. Among all measures reported, we identified those that were “topped out” (i.e., measures considered indiscriminate by Medicare because high performance is easily achieved) and those which were relevant for patients with urologic conditions (i.e., MIPS urology measures, qualified urologic registry measures, or those relevant to surgical care). RESULTS: 8,297 urologists reported in MIPS during the 2020 performance year, of whom 14% reported as an individual, 56% as a part of a group, and 30% as part of an APM. Among the top 10 most frequently reported measures, none were specific for urologic care (Table 1). 65% of individual urologists, 58% of those in groups, and 92% in APMs reported at least 1 or more “topped out” measures. Only 11% of urologists reported measures that were directly relevant to patients with urologic conditions. CONCLUSIONS: Most measures reported by urologists are not directly relevant to patients with urologic conditions and remain a poor indicator of the quality of urologic care provided. As Medicare transitions MIPS to condition specific quality measures, it will be important for the urology community to develop and submit measures that will be most impactful for patients. Source of Funding: Avinash Maganty is supported by funding from the National Cancer Institute Ruth L. Kirschstein Postdoctoral Award F32 Grant F32 CA275021-01 © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e655 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Avinash Maganty More articles by this author Noah Krampe More articles by this author Anup Shah More articles by this author Vishnukamal Golla More articles by this author Expand All Advertisement PDF downloadLoading ...

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• Telehealth patterns in primary and onco-primary care

  Cancer Survivorship Research & Care · 2023-01-01 · 1 citations

  articleOpen access1st author

  Introduction The COVID-19 pandemic spurred telehealth use in US oncological care but there remains limited data on the onco-primary cancer survivorship population. We investigated patterns of telehealth use during the pandemic and factors driving utilization.Methods and Materials Retrospective study of patients aged 21 years and older diagnosed with breast, colorectal, prostate or non-small lung cancer (stages 1–4). The study period evaluated was defined as during COVID-19: March 1, 2020–April 30, 2021. Patient cohorts were defined as “ever telehealth users” and “never telehealth users”. We tested between-cohort differences in baseline characteristics using Pearson's chi-square tests.Results We identified 4931 onco-primary patients. Of these patients 36.7% (n= 1812) were “ever cancer telehealth users” and 63.3% (n = 3119) patients were “never cancer telehealth users.” Among telehealth users, 44.6% were 65 years or older at cancer diagnosis, 24% were Black, 24.1% lived in rural settings and the most common cancer types were breast (40.4%) followed by prostate (30.4%). “Never telehealth user” had similar demographics. Increased telehealth use was seen in those patients with a higher baseline comorbidity burden (RR 1.14; 95% CI 1.06–1.23), prostate cancer (Prostate RR 1.33; 95% CI 1.16–1.54) and advanced stage cancer (RR 1.20; 95% CI 1.08–1.34).Conclusion Telehealth, while not as heavily utilized, remains an important care tool in marginalized rural and Black onco-primary care patients.Implications for Practice This paper highlights baseline use rates of telehealth in the onco-primary patients including more health disparate populations and helps guides future healthcare system investments in this technology.

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• Rural For-Profit Hospitals Are Associated With Higher Commercial Prices for 3 Common Urological Procedures

  Urology Practice · 2023 · 2 citations

  • Medicine
  • Medical emergency
  • Emergency medicine

  INTRODUCTION: Rural patients lack access to urological services, and high local prices may dissuade underinsured patients from surgery. We sought to describe commercially insured prices for 3 urological procedures at rural vs metropolitan and for-profit vs nonprofit hospitals. METHODS: A cross-sectional analysis of commercially insured prices from the Turquoise Health Transparency data set was performed for ureteroscopy with laser lithotripsy, transurethral resection of bladder tumor, and transurethral resection of prostate. Hospital characteristics were linked using the Centers for Medicare and Medicaid Services Healthcare Cost Reporting Information System. Linear modeling analyzed median hospital price and its association with hospital characteristics. RESULTS: < .001). CONCLUSIONS: Prices are higher for 3 common urological surgeries at rural for-profit hospitals. Differential pricing may contribute to disparities for underinsured rural residents who lack access to nonprofit facilities. Interventions that facilitate transportation and price shopping may improve access to affordable urological care.

  PublisherDOI

• Merit-based Incentive Payment System Quality Reporting in Urology Practices

  Urology Practice · 2023-03-02 · 3 citations

  articleOpen accessSenior author

  INTRODUCTION: Most urologists are required to participate in Merit-based Incentive Payment System-an alternative payment model in which physicians must track and report quality measures. However, Merit-based Incentive Payment System measures are urology-specific, and it remains unclear what measures urologists are choosing to track and report. METHODS: We performed a cross-sectional analysis of Merit-based Incentive Payment System measures reported by urologists for the most recent performance year. Urologists were categorized by their reporting affiliation (ie, individual, group, or alternative payment model). We identified the measures most frequently reported by urologists. Among reported measures, we identified those that were specific to urological conditions and those that were "topped out" (ie, measures considered indiscriminate by Medicare because high performance is easily achieved). RESULTS: A total of 6,937 urologists reported in Merit-based Incentive Payment System during the 2020 performance year, of whom 14% reported as an individual, 56% as a group, and 30% as an alternative payment model. Among the top 10 most frequently reported measures, none were urology-specific. Eleven percent of urologists reported measures that were directly specific to urological conditions; 65% of individual urologists, 58% of those in groups, and 92% in alternative payment models reported at least 1 or more "topped out" measures. CONCLUSIONS: Most measures reported by urologists are not specific to urological conditions, and therefore performance within Merit-based Incentive Payment System may be a poor indicator of the quality of urological care provided. As Medicare transitions Merit-based Incentive Payment System to implement specific quality measures, the urological community will need to develop and submit measures that will be most impactful for urology patients.

  PublisherOA PDFDOI

• Financial Health of People Living With Dementia and Their Informal Care Partners: Protocol for a Mixed Methods Study (Preprint)

  2023-03-14

  preprintOpen access

  <sec> <title>BACKGROUND</title> There is a growing body of academic literature focusing on the significant financial burdens placed on people living with cancer, but little evidence exists on the impact of rising costs of care in other vulnerable populations. This financial strain, also known as financial toxicity, can impact behavioral, psychosocial, and material domains of life for people diagnosed with chronic conditions and their care partners. New evidence suggests that populations experiencing health disparities, including those with dementia, face limited access to health care, employment discrimination, income inequality, higher burdens of disease, and exacerbating financial toxicity. </sec> <sec> <title>OBJECTIVE</title> The three study aims are to (1) adapt a survey to capture financial toxicity in people living with dementia and their care partners; (2) characterize the degree and magnitude of different components of financial toxicity in this population; and (3) empower the voice of this population through imagery and critical reflection on their perceptions and experiences relating to financial toxicity. </sec> <sec> <title>METHODS</title> This study uses a mixed methods approach to comprehensively characterize financial toxicity among people living with dementia and their care partners. To address aim 1, we will adapt elements from previously validated and reliable instruments, including the Comprehensive Score for Financial Toxicity and Patient-Reported Outcomes Measurement Information System, to develop a financial toxicity survey specific to dyads of people living with dementia and their care partners. A total of 100 dyads will complete the survey, and data will be analyzed using descriptive statistics and regression models to address aim 2. Aim 3 will be addressed using the process of “photovoice,” which is a qualitative, participatory research method that combines photography, verbal narratives, and critical reflection by groups of individuals to capture aspects of their environment and experiences with a certain topic. Quantitative results and qualitative findings will be integrated using a validated, joint display table mixed methods approach called the pillar integration process. </sec> <sec> <title>RESULTS</title> This study is ongoing, with quantitative findings and qualitative results anticipated by December 2023. Integrated findings will enhance the understanding of financial toxicity in individuals living with dementia and their care partners by providing a comprehensive baseline assessment. </sec> <sec> <title>CONCLUSIONS</title> As one of the first studies on financial toxicity related to dementia care, findings from our mixed methods approach will support the development of new strategies for improving the costs of care. While this work focuses on those living with dementia, this protocol could be replicated for people living with other diseases and serve as a blueprint for future research efforts in this space. </sec> <sec> <title>INTERNATIONAL REGISTERED REPORT</title> DERR1-10.2196/47255 </sec>

  PublisherDOI

• Financial Health of People Living With Dementia and Their Informal Care Partners: Protocol for a Mixed Methods Study

  JMIR Research Protocols · 2023-06-01 · 3 citations

  articleOpen access

  BACKGROUND: There is a growing body of academic literature focusing on the significant financial burdens placed on people living with cancer, but little evidence exists on the impact of rising costs of care in other vulnerable populations. This financial strain, also known as financial toxicity, can impact behavioral, psychosocial, and material domains of life for people diagnosed with chronic conditions and their care partners. New evidence suggests that populations experiencing health disparities, including those with dementia, face limited access to health care, employment discrimination, income inequality, higher burdens of disease, and exacerbating financial toxicity. OBJECTIVE: The three study aims are to (1) adapt a survey to capture financial toxicity in people living with dementia and their care partners; (2) characterize the degree and magnitude of different components of financial toxicity in this population; and (3) empower the voice of this population through imagery and critical reflection on their perceptions and experiences relating to financial toxicity. METHODS: This study uses a mixed methods approach to comprehensively characterize financial toxicity among people living with dementia and their care partners. To address aim 1, we will adapt elements from previously validated and reliable instruments, including the Comprehensive Score for Financial Toxicity and Patient-Reported Outcomes Measurement Information System, to develop a financial toxicity survey specific to dyads of people living with dementia and their care partners. A total of 100 dyads will complete the survey, and data will be analyzed using descriptive statistics and regression models to address aim 2. Aim 3 will be addressed using the process of "photovoice," which is a qualitative, participatory research method that combines photography, verbal narratives, and critical reflection by groups of individuals to capture aspects of their environment and experiences with a certain topic. Quantitative results and qualitative findings will be integrated using a validated, joint display table mixed methods approach called the pillar integration process. RESULTS: This study is ongoing, with quantitative findings and qualitative results anticipated by December 2023. Integrated findings will enhance the understanding of financial toxicity in individuals living with dementia and their care partners by providing a comprehensive baseline assessment. CONCLUSIONS: As one of the first studies on financial toxicity related to dementia care, findings from our mixed methods approach will support the development of new strategies for improving the costs of care. While this work focuses on those living with dementia, this protocol could be replicated for people living with other diseases and serve as a blueprint for future research efforts in this space. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/47255.

  PublisherOA PDFDOI

• MP16-02 WORK PRODUCTIVITY OF PATIENTS UNDERGOING TRIAL OF PASSAGE FOR URETERAL STONES

  The Journal of Urology · 2023-03-23

  article

  You have accessJournal of UrologyCME1 Apr 2023MP16-02 WORK PRODUCTIVITY OF PATIENTS UNDERGOING TRIAL OF PASSAGE FOR URETERAL STONES Ian Berger, Alexandria Spellman, Vishnukamal Golla, Michael Lipkin, Gary Faerber, Jodi Antonelli, Charles Scales, and Deborah Kaye Ian BergerIan Berger , Alexandria SpellmanAlexandria Spellman , Vishnukamal GollaVishnukamal Golla , Michael LipkinMichael Lipkin , Gary FaerberGary Faerber , Jodi AntonelliJodi Antonelli , Charles ScalesCharles Scales , and Deborah KayeDeborah Kaye View All Author Informationhttps://doi.org/10.1097/JU.0000000000003236.02AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Ureteral stones affect patients of working age and disrupt daily activities. Patient reported outcomes during trial of passage are understudied which hinders counseling and expectation setting. We sought to characterize work productivity losses for patients with a ureteral stone undergoing a trial of passage. METHODS: We identified employed, English speaking patients aged 18-64 years and discharged from Duke University Health System EDs with unilateral ureteral stones on CT scan from February-October 2022. Patients were contacted by phone 4 weeks after discharge and administered the Institute for Medical Technology Assessment Productivity Cost Questionnaire which evaluates three domains of productivity loss over a four-week period: absenteeism (missed work), presenteeism (decreased productivity at work), and volunteerism (help with unpaid work or domestic tasks). Patients were designated as reporting passage of their stone if they noticed it in the toilet or identified a day with symptom resolution that did not return. RESULTS: We enrolled 64 patients who completed the survey. 71% (46/64) had distal stones and 14% (9/64) had symptoms at the time of the survey. 73% (47/64) of patients missed work after discharge (Figure 1), missing a median of 2 days (interquartile range [IQR] 1.0-4.0). 58% (37/64) had pain at work, with a median of 3 days of pain (IQR 1.5-6.5) and a median of 40% reduction in productivity (IQR 20%-50%) on symptomatic days. 38% (24/64) required help with unpaid work for a median of 2.5 days (IQR 1.0-5.8) and median of 3.5 hours per day (IQR 2.0-5.0). 58% (37/64) of patients passed their stone with a median passage time of 3.5 days (IQR 2.0-7.8). Of patients who passed their stone, 68% (25/37) missed work, with a median of 2 days missed (IQR 1-2) or 50% of work days until their stone passed (IQR 21%-83%). Of patients who reported not passing their stone, 74% (20/27) missed work for a median of 4.5 days (IQR 1-7). This was a median of 14% (IQR 3%-22%) of days until surgery or survey completion. CONCLUSIONS: The majority of patients miss work during passage of a ureteral stone. While time off work is less than published rates after ureteroscopy, it is common to miss half of work days until the stone passes. This information may aid patient counselling and help to prevent return ED visits. Download PPT Source of Funding: None © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e201 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.Metrics Author Information Ian Berger More articles by this author Alexandria Spellman More articles by this author Vishnukamal Golla More articles by this author Michael Lipkin More articles by this author Gary Faerber More articles by this author Jodi Antonelli More articles by this author Charles Scales More articles by this author Deborah Kaye More articles by this author Expand All Advertisement PDF downloadLoading ...

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Frequent coauthors

• Karim Chamie

  46 shared

• Deborah R. Kaye

  Duke Cancer Institute

  28 shared

• Douglas S. Tyler

  Kuwait Petroleum Corporation (Kuwait)

  22 shared

• Yong Shan

  The University of Texas Medical Branch at Galveston

  22 shared

• John L. Gore

  Cape Town HVTN Immunology Laboratory / Hutchinson Centre Research Institute of South Africa

  22 shared

• Stephen B. Williams

  The University of Texas Medical Branch at Galveston

  22 shared

• Andrew T. Lenis

  20 shared

• Hemalkumar B. Mehta

  Johns Hopkins University

  19 shared