Tremendous consolidation of remaining independent oncology practices is very likely under scenarios painted by panelists at the 4th annual meeting of Patient-Centered Oncology Care,
presented by The American Journal of Managed Care
The closing panel discussion of the 2-day event brought together an independent practice representative and a former director of medical policy development for the FDA. CMS has a strong desire to make accountable care organizations (ACOs) work, but there are many variables, and panelists said further experimentation with this form of care could have the effect of driving physicians out of fee-for-service (FFS) and into Medicare Advantage, where group health programs administer Medicare payment.
However, the degree to which oncology practices will participate in this migration is unclear because many of them are falling into the gravitational pull of expanding hospital systems, the panelists said. Yale-New Haven Hospital is an example of a growing, all-encompassing conglomerate, said participant Ted Okon, executive director of the Community Oncology Alliance (COA): “What’s called Jaws in Connecticut is also known as Yale. They’ve bought up everything in the entire state.”
CMS has attempted to tailor ACOs to a variety of health organizations so that each is comfortable with the level of risk it is undertaking though participation. The Medicare Access & CHIP Reauthorization Act, for example, offers the choice of participation in an alternative payment model or FFS. Similarly, the Oncology Care Model, scheduled for launch in spring of 2016, allows for innovative forms of reimbursement.
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