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To Risk or Not to Risk? Or Is Risk Contracting Too Risky?

Dawn Holcombe, MBA, FACMPE, ACHE

February 2019, Vol 9, No 2 - From the Editor

The word on the street is that value-based, or risk-based, oncology contracts for physicians are the inevitable wave of the future. But are they? I had a conversation late last year with someone in the federal government. We were discussing whether oncology practices should be accepting the modified alternative risk model that has recently been offered to them under the Oncology Care Model (OCM) program. This individual felt very strongly that payment programs that put oncologists at full risk for their patients’ treatment costs (including drug costs) were so imminent that it would be irresponsible for practices to not accept the modified alternative risk model as soon as possible so that they can be prepared. [ Read More ]

What Does the Future Hold for PBMs? Implications for Oncology Practices

Dawn Holcombe, MBA, FACMPE, ACHE

October 2018, Vol 8, No 10 - From the Editor

Pharmacy benefit managers (PBMs) have been seeking greater influence in the oncology market for several years. They are contracted by health plans and employers to manage the drugs covered under pharmacy benefits, which may include newly approved drugs added to the plan; provision of operational controls, such as step edits; prior authorizations; formulary restrictions; and the review of medical necessity for oral medications. [ Read More ]

Will Oncologists Change Their Treatment Patterns Based on New Clinical Evidence?

Dawn Holcombe, MBA, FACMPE, ACHE

July 2018, Vol 8, No 7 - From the Editor

In medical parlance, there is a wide gap between the terms “prognostic” and “predictive.” At a plenary session at the 2018 American Society of Clinical Oncology (ASCO) meeting, results presented from the TAILORx clinical trial cast a spotlight on that gap, and narrowed it. The question now is, will physicians and patients take action and cease the use of chemotherapy when its effectiveness can be predictively deemed ineffective, despite the challenges of hope and habit? [ Read More ]

The Promise and Peril of Technology

Dawn Holcombe, MBA, FACMPE, ACHE

April 2018, Vol 8, No 4 - From the Editor

What seems like just a few years ago, oncology practice technology amounted to a billing system and an electronic medical records (EMR) system, possibly even a drug inventory management system. When a practice participated in quality or performance metrics, such as the American Society of Clinical Oncology Quality Oncology Practice Initiative, it was usually through the process of a manual chart review conducted for a subset of patients being treated by the group. [ Read More ]

Authority Over Medical Practices—Something to Watch

Dawn Holcombe, MBA, FACMPE, ACHE

February 2018, Vol 8, No 2 - From the Editor

In the snow-covered fields of New Hampshire, things have been heating up for medical practices that reconstitute and infuse drugs. In November 2017, the New Hampshire Board of Pharmacy paid surprise inspections to several medical practices (outside of oncology) to review their compliance with US Pharmacopeial Convention Chapter 797 (USP 797) standards for sterile compounding. [ Read More ]

Slowing Down to Move Forward: The Summer of 2017 May Be Pivotal for Oncology Practices

Dawn Holcombe, MBA, FACMPE, ACHE

July 2017, Vol 7, No 7 - From the Editor

This year has been more hectic for practice administrators than I have seen in decades. Practice administrators keep telling me they feel they are working harder and harder, and have so many more demands on the practice involving reporting, chasing reimbursement, securing access for their patients, and helping their physicians navigate the increasing demands on them, that it is just too hard to keep up. [ Read More ]