Creating an Oncology Practice Plan That Can Change with the Times

Abstract

In Brief Medical oncologist workflows have changed dramatically in view of precision medicine, new therapeutic agents, and sub-specialization in oncology. Relative value unit (RVU)-based practice plans lack financial incentive for cooperation and sharing of knowledge and patients, which is required for current best practices in cancer care. To improve cooperation and sharing, Aurora Health Care formed a Practice Plan Development Committee of medical oncologists, service line leadership, finance leadership, and a practice plan consultant. The committee established goals that would enhance collaboration, modify physician behavior to meet the needs of the group, allow payment for non-RVU-generating activities, create a more equitable distribution of expertise, facilitate intra-group consultation, and create more evenly developed compensation. A plan was developed to reward non-RVU-generating activities that benefited the cancer program and medical group. This plan included the creation of a pool where a percentage of compensation, above a threshold, was established and equally divided at the end of the calendar year. Citizenship criteria were established to benefit the health system, medical group, and individuals and demonstrably modified behavior. All members of the medical group (physician practice) agreed to move to the new model. It has resulted in continuous improvement of defined goals with reduced variation in income, increased clinical trial volume by 400 percent, and increased sub-specialization within the medical oncology group.