Enhancing Oncology's Business Case: How the Hospital Can Help.

Abstract

Oncologists are facing unprecedented business challenges. Perhaps even more dramatically than other specialties, oncology is struggling to meet the burgeoning mandates for demonstrated quality and performance, fraud and abuse avoidance, risk management, and efficiency as their fundamental business model predicated on revenues from pharmaceuticals reaches a crossroads. Whereas there are many things that oncologists could do to enhance their practice efficiencies, and thereby improve their financial margins,1 the hospitals to which oncologists primarily relate can also be a source of help. There is considerable mythology, which has impeded the development of creative techniques by which hospitals and their medical staff members can collaborate, not only in the furtherance of quality, but also to enhance the physicians' business case as well (see “Five Principles to Enhance the Physicians' Business Case for Quality”). Many hospitals, and even their legal advisors, are so fearful of potential liability under the Stark statute and the anti-kickback statute (AKS) that they thwart creative thinking in these arenas. This article elaborates on three areas of the law that have impeded more effective hospital-oncology relationships, and sets forth four practical strategies by which hospitals can help oncologists without running afoul of the law.