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Much Ado About MACRA

Several clients and provider contacts expressed concern last week about how changing reimbursement methodologies may force IDNs and even community-based oncology medical groups to develop “population-based health” strategies for their patients. Client concerns include the risk of late-stage patients being diverted to hospice, and financial incentives to avoid prescribing branded cancer drugs. Providers we’ve spoken [...]

September 24th, 2016|

IDNs Struggle to Execute

Financial results for four large and sophisticated IDNs illuminate some of the challenges these organizations face as they deepen their integration and simultaneously cope with changing reimbursement models. Banner Health, Sutter Health, and Highmark Health all reported sharply declining earnings for 2015 compared to 2014, despite increasing revenue, while Partners announced a steep decline in [...]

April 29th, 2016|

Value for Whom?

Cancer has historically been among the most expensive diseases to treat due to drug and other costs.  Drug pricing became a specific topic of broad discussion amongst providers with the Gleevec’s arrival in 2001, with a launch price of approximately $2,200/month.  Prices for branded agents continued to rise steadily, with Erbitux pushing the trend upward [...]

April 11th, 2016|

The Pricing Pundits Continue Marching Toward Would-Be Czardom

JCO recently published an article by a radiation oncologist at Stanford, and apparently believed it was important enough to make it an “Editor’s Pick.” The article describes a cost effectiveness study conducted with a rigorous and well-documented methodology. Peter Bach provides an editorial that initially lauds the oncologist's work, but then veers away toward his recurring [...]

April 11th, 2016|