CMS Puts On Its Poker Face

Oncology Business News®, June 2016,

The saying on Wall Street is "sell in May and go away," but there's no detaching from the cliffhanger that CMS has left in the air.

OncLive Chairman,

Mike Hennessy

The saying on Wall Street is “sell in May and go away,” but there’s no detaching from the cliffhanger that CMS has left in the air. It’s anybody’s guess what will happen with Medicare Part B and the proposal to change the drug payment formula for drugs administered in a physician’s office. The Community Oncology Alliance (COA), ASCO, and other physician groups have stirred up such a rumble in Congress over this potential rule change that CMS can hardly pretend not to notice. There are no signs of disquiet behind the grey façade of the CMS headquarters building in Maryland, but although the official public comment period on this controversial payment adjustment has ended, it is clear that physicians will not allow the matter to rest. Stay tuned, and visit often for updates.

Our issue of Oncology Business Management this month is packed with insightful material on ongoing issues that are highly relevant to your practice operations. Our story on direct contracting by Meir Rinde asks whether bypassing the payer has any potential for improving patient care and practice health in the oncology community. We talked again with Comprehensive Care Centers of Nevada, which has negotiated a successful direct contracting deal with a 57,000 member culinary union in Las Vegas. We learned how that deal works and how similar forms of direct contracting could succeed elsewhere in the country. The Florida Health Care Coalition is working to pioneer a similar program that would launch in January. This is a story well worth updating, so be sure to read this month’s article and expect to see more.

On the subject of scale, Florida Cancer Specialists & Research Institute (FCS) has engineered 37 mergers with independent practices and continues to grow. At the Community Oncology Alliance (COA) annual meeting in April, FCS CEO Brad Prechtl gave a thorough rundown on the science of merging practices and the economies that can be achieved.

FCS measures 2176 employees and still considers itself an independent. It has added 135 physicians in just the last five years, for a total of 204. Centralized functions have cut expenses dramatically, and scale has enabled the practice to add numerous offerings that smaller independents couldn’t provide.

Prechtl, perhaps hoping to land a few prospective merger partners at the COA conference, did not hold back on the numbers. Diversification of revenues has enabled FCS to lower its dependence on chemotherapy revenues. Chemo is just over 63% of the group’s revenue base, as opposed to an industry average of 81%. Malpractice coverage has dropped 64% since 2009, and accounts receivable collections are achieved, on average, five days faster than the industry average. FCS achieved all of this without having to fold into a hospital system. Could this be a model for the rest of the country? Read all about it in this month’s issue.

There’s lots more on the menu this month. How to divide up the workday is the oncologist’s constant dilemma. Three of our stories address the time element from different angles. Our story on busy doctors by Gina Battaglia addresses the growing demands on oncologists’ time. Our story on potential Maintenance of Certification changes talks about how the American Board of Internal Medicine plans to ease the burden of keeping up with assessment needs. And our story on payer requirements for genetic counseling discusses whether oncologists have the time and required expertise to continue performing this function themselves.

It’s all here in the June issue of Oncology Business Management. Read and enjoy!