October 2016

The evolving healthcare landscape creates many challenges for community-based oncology practices. As the market shifts from fee-for-service to value-based care, practices are tasked with improving quality while reducing costs.

Nearly a decade ago, CMS started healthcare providers on the road to value-based care. Along the way, we have seen a variety of quality programs that impact community oncologists.

In June, CMS selected roughly 200 medical oncology practices to participate in the public payer’s own flavor of oncology payment reform: the Oncology Care Model. This program, which launched in July, is designed to lower costs and improve quality of care for treatment episodes that start with a six-month chemotherapy regimen.

Fee-for-service remains the primary driver of patient revenue for the majority of oncology practices across the country, and the same is true for The Center for Cancer and Blood Disorders.

Edward P. Ambinder, MD, discusses advances on improving the interoperability of computer technology to facilitate the sharing and security of patient records for the purposes of furthering patient-centric, coordinated, and value-based care.

After flat-fee system of financing cancer care at two large oncology practices in Northern California has improved patient outcomes and increased doctor compensation while defying inflationary pressures and holding the line on treatment costs.

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.

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.

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.