Abstract

Within community practice, we are faced with the dual challenge of providing health care and operating a viable business entity. This problem is not unique to oncology; however, the specialty has been unfairly burdened with preferential payment incentives that favor treatment in hospital outpatient departments (HOPDs) over independent communitybased clinics. This trend toward HOPD care has caused a shift in the model of delivery of care and remains a problem for those who practice in community clinics. Furthermore, the shift is driving spending for oncology care higher at a time when payers and patients are contending with rising, unsustainable costs. Providers in individual practices who are focused on the daily responsibilities of caring for cancer patients understandably may find it difficult to keep abreast of national policy changes and understand how those changes might affect their ability to take care of patients. The US Oncology Network and the Community Oncology Alliance (COA) are collaborating to interpret this proposed policy change and to make recommendations for improvement to empower community oncologists to comprehend the impact of this policy and to work toward a better outcome. We will present this proposed policy change in 2 parts: first, an analysis of the impact of current policies on community oncology practice, and second, recommendations for proposed changes to ensure balanced payment amounts for delivery of equivalent services and strategic initiatives for valuebased cost reduction.

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