Oncology Business Management

Although many reform efforts are based on good intentions, these efforts are not always well respected. There is a drive afoot to terminate the charter for the Center for Medicare & Medicaid Innovation.

The FDA has granted a priority review designation to daratumumab (Darzalex) in combination with lenalidomide and dexamethasone or bortezomib and dexamethasone for patients with relapsed multiple myeloma following at least 1 prior therapy.

As the FDA considers a supplemental biologics license application for 2 daratumumab-based triplet regimens in multiple myeloma, the results for 1 of the pivotal phase III studies supporting the sBLA have been published in The New England Journal of Medicine.

One by one, major payers have announced they will withdraw from many Affordable Care Act marketplaces at the end of this year, leaving residents of hundreds of counties with just one or two payers selling policies on the government-run exchanges.

The tide of closings, mergers, and acquisitions among independent oncology clinics remains strong but appears to be tapering a bit

The FDA has granted a breakthrough therapy designation to alectinib (Alecensa) as a frontline treatment for patients with ALK-positive non–small cell lung cancer.

Patrick Conway, MD, says that the demonstration drug pricing plan, which would raise payment for low-cost drugs and lower payment for high-priced drugs, is chiefly about improving outcomes.

When it comes to health coverage, most Americans face an unnerving reality—they have no idea what is covered under their health insurance policy until they are affected by illness or disease.

As the cost comes down due to new technologies and as studies mature, maybe the value equation for common malignancies will favor proton beam therapy. However, it is hard to imagine how throwing a house will ever be as cost-efficient as throwing a marble.

Although the MIPS and MACRA rule is preliminary and subject to change, CMS is clearly putting a lot of weight into it, and the act will be a major part of oncology practice.

Andrew L. Pecora, MD, discusses the value changes that CMS is mandating, and how it takes enormous planning and study.

In its re-interpretation of CMS policy for Medicare Part D drug dispensing, CVS Health has gone against years of allowing in-house physician dispensaries to participate in Medicare Part D.

The first proton beam therapy units cost huge amounts of money and were well beyond the means of all but the most well-financed cancer centers. However, this technology is vastly cheaper than before.

The PD-L1 inhibitor atezolizumab has been found to be non-toxic and has demonstrated a major survival advantage in patients with metastatic urothelial bladder cancer.

CMS has scaled back the implementation of physician reporting requirements under the Quality Payment Program of medical value improvement created under the Medicare Access and CHIP Reauthorization Act legislation.

Higher insurance premiums, deductibles, and co-pays, along with the increased cost of cancer care, have made it more complicated to find aid.

The FDA has granted a priority review to a supplemental biologics license application for pembrolizumab (Keytruda) as a first-line treatment for patients with PD-L1–positive non–small cell lung cancer.

It's clear that Medicare needs a proactive cancer strategy, hence the launch of the Oncology Care Model.

A move by CVS Health to place in-house physician dispensaries out-of-network for purposes of Medicare Part D drug payment would force hundreds of thousands of cancer patients across the country to find alternate sources for their oral oncolytic drugs.

Preauthorizations for chemotherapy drugs and payers’ differing administrative requirements are two of the main contributors to greater hiring needs. Oncologists and practice managers also cite frequent coverage denials, lengthy appeal processes, payerspecific clinical pathways, financial counseling for underinsured patients, data-tracking initiatives, and night and weekend nurse triage services.

Oncology practices should protect themselves from the danger of having their IT systems hacked by having a risk analysis done to identify potential access and compromise points.

Pfizer has announced plans to acquire the biopharmaceutical company Medivation, which is the developer of the androgen receptor inhibitor enzalutamide (Xtandi).

Despite the anxiety and a few tears, Pontchartrain Cancer Center made the conscious decision to "buy in" to the concept and worked as a group to prepare for and implement electronic health records.

Andrew L. Pecora, MD, president of the Physician Services Division and chief innovation officer at Hackensack Meridian Health, discusses the Oncology Care Model (OCM) and other aspects of healthcare reform.

We consider what we do to patients through prescription or procedure as a potential source of harm, followed less so by our behavior, when we fail to be caring or courteous.

Multiple resources are available to help community oncologists maintain success by increasing awareness of their practice, providing the most innovative treatments to their patients, and preparing for the future of oncology care.

Andrew L. Pecora, MD, president of the Physician Services Division and chief innovation officer at Hackensack Meridian Health, discusses the Oncology Care Model (OCM) and other aspects of healthcare reform.

Andrew L. Pecora, MD, president of the Physician Services Division and chief innovation officer at Hackensack Meridian Health, discusses the Oncology Care Model (OCM) and other aspects of healthcare reform.

Andrew L. Pecora, MD, president of the Physician Services Division and chief innovation officer at Hackensack Meridian Health, talked about the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) and other aspects of healthcare reform.

Andrew L. Pecora, MD, president of the Physician Services Division and chief innovation officer at Hackensack Meridian Health, discusses the Medicare Part B Drug Payment Model (OCM) and other aspects of healthcare reform.