Consolidation of Oncology Care Continues

Ted Okon

A new report released by the Community Oncology Alliance (COA) in June has found that an approximately 20% increase was seen in both community oncology clinics closing as well as making arrangements or merging with hospitals from a previous report released just over a year ago, demonstrating a continuing trend toward the consolidation of cancer care delivery.

The 2013 Community Oncology Practice Impact Report, updating results from a report previously issued 15 months prior, compiled data on 1338 community oncology clinics from across the country from both public and private sources.

According to the report, during the past 6 years, 288 clinics have closed, 407 practices are struggling financially, 43 practices are sending all of their patients elsewhere, 469 practices have made an agreement with or have been purchased by a hospital, and 131 practices have merged or been acquired by a private entity other than a hospital.

Even though the report showed decreases in the number of clinics struggling financially, sending patients elsewhere, and mergers or acquisitions, those statistics are the result of clinics closing or partnering with hospitals.

According to the report, in 2005, more than 85% of chemotherapy was administered in community cancer clinics. However, in 2011, 33% of all chemotherapy administration occurred in the hospital outpatient setting, compared with 13.5% in 2005.

The report suggests that the shift of cancer treatment away from the community setting has important cost implications. In 2011, a cancer patient receiving chemotherapy in a community clinic cost Medicare $6500 less per patient annually than treating patients in other settings. Further, Medicare payments for chemotherapy administration rose from $98.3 million in 2005 to $300.9 million in 2011, while reimbursement for physician clinic administrations decreased from $507.5 million in 2005 to $433.8 million in 2011.

“The Community Oncology Alliance has been collecting data about cancer clinic closures and hospital acquisitions for several years,” said Ted Okon, Executive Director of the Community Oncology Alliance, in a statement. “[This] study quantifies what we have been seeing—cancer care is consolidating towards the higher cost setting. Unfortunately, the Medicare sequester cut is accelerating this shift in cancer care by forcing some clinics to send seniors to the hospital for treatment and others to consider merging with hospitals. Congress and the White House have to act immediately before the bank is permanently broken for seniors and Medicare.”