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ASCO Fights Perception That Independents Get Short Shrift

Tony Hagen @oncobiz
Published: Thursday, Mar 30, 2017

Daniel F. Hayes, MD

Daniel F. Hayes, MD

ASCO is working hard to overcome a perception that it has not been truly representative of smaller, independent oncology practices throughout the United States, said Daniel F. Hayes, MD, president of the ASCO, which is the largest association of working oncologists in the country.

Hayes, who sat down with OncLive at the midpoint of his 1-year term as president, said ASCO is increasingly reaching out to independent oncology practices, paying closer attention to their needs, and supplying them with tools and services to manage the difficult transition to value. Joining him for the interview was Stephen S. Grubbs, MD, vice president of Clinical Affairs for ASCO. Grubbs is leading many of the practice education and quality improvement initiatives at the organization.

The 2 doctors discussed wide-ranging topics that included the change of administrations in Washington, DC, and what that may mean for the direction and consistency of the reform program at CMS. They also discussed the growing influence and power of pharmacy benefit managers (PBMs) over the supply of oral oncolytics and the effect of this control over independent practices. In addition, they covered physician recruitment difficulties, medical school training, the use of advanced practice providers (APPs), and the very future of independent oncology practices in a landscape of increasing consolidation and economic challenge.

OncLive: How might Thomas Price, MD, recently appointed to the position of US Secretary of Health and Human Services, influence healthcare policy in Washington, DC?

Hayes: We congratulate Dr Price and look forward to his tenure. He has a lot on his plate right now, including what to do to repeal and replace the Affordable Care Act. At ASCO, we have a variety of things we’re concerned about. Our main concern is that patients who are at risk or have cancer or are recovering from it have access to care without preconditions and that they have access to clinical trials. We are also confident that Dr Price will continue to be an advocate for increased funding at the National Institutes of Health and the National Cancer Institute. He was a major supporter of the 21st Century Cures Act.

Do you expect a change in the focus of CMS’ reform efforts, particularly with respect to implementation of the Medicare Access and CHIP Reauthorization Act (MACRA)?

Hayes: I don’t think any of us know. ASCO’s not going to change its principles. We are all about taking better care of our patients, so our principles are that patients should continue to have access to affordable and high-quality care. We’ve been supportive and have worked with CMS as they’ve begun to develop quality and value-based reimbursement as opposed to fee-for-service. MACRA is not perfect, but to their credit, CMS has worked with us and has accepted many of our recommendations. Ultimately we will have something that physicians and oncologists embrace.

What’s the role of the smaller, independent oncology practice in this changing landscape?

Hayes: Almost 90% of patients who are treated for cancer in this country are treated by community oncologists. That definition is getting fuzzy, as we have more and more partnerships between what used to be true private practices and true academic practices. They’re beginning to come together and merge. What we really care about is whether patients have access to high-quality care, no matter where it is. And there are practices in this county that are not being encompassed by academic centers that will remain independent practices, and a third of our patients are in those. That’s a complex environment.

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