“Benchmarking is one of the best, most efficient ways to find opportunities to improve your practice,” suggest Carla Balch and colleagues in the new oncology National Practice Benchmark (NPB) annual report.1 “It is our hope that this NPB will serve as the bench on which to rest your instruments and business processes to measure deviations from other oncology practices in the nation,” the authors added.1
The new report provides insightful information regarding oncology providers’ productivity, costs, practice revenues, and profits. Key findings from the 2015 report show that new patient visits and average drug spending are on the rise and highlight specific opportunities to improve oncology practices.
Oncology Practice Trends
More than 1700 medical oncologists, radiation oncologists, and practice administrators from more than 200 community practices and cancer centers across the country were invited to participate in the 2014 NPB online survey. Overall, the data covered the year 2014 or the most recently completed 12-month fiscal period, and reflect 42 oncology practices in 23 states. This represents 587.8 full-time equivalent hematology/oncology physicians and 755.5 physicians in all specialties.
Of note, 91% of responding practices were physician owned; only 7% were owned by a hospital, and 2% were freestanding cancer centers owned equally by 2 hospitals.
Physician productivity can be analyzed using different measures. An important predictor of financial health is the number of new patients served by the practice. A new patient visiting the practice is defined as a patient who has not been seen by a clinician in the exact specialty at the practice in the past 3 years.
Based on the data collected, the total number of new patient visits in a 12-month period per 1 hematology/oncology physician was 358, representing an increase from the 325 in new patient visits for 1 hematology/oncology physician reported last year.
One new metric measured in this year’s report was hospital visits as a percentage of total patient visits for 34 oncology practices, based on 569.6 full-time equivalent hematology/oncology physicians.
Healthcare expenditures is a key benchmark for all stakeholders, and for oncology practices. The new NPB report shows that the adjusted average spending on cancer drugs per 1 hematology/oncology provider this year was $3.6 million compared with the $3.1 million reported last year, an increase in drug costs that will not surprise any cancer care providers.
Impact of Oral Oncolytics
Of note, total infusions per 1 chemotherapy administration staff saw a slight decline compared with last year. The researchers note that the view of initial chemotherapy administrations as a productivity measure may need to be amended in future NPB reports to reflect the increasing number of oral chemotherapy drugs. Oral drugs require patient education, which is usually done by a staff member.
Furthermore, with the rise in oral cancer drugs, in-house and specialty pharmacy dispensing is an increasingly important topic for oncology practices. The majority of oral prescriptions are currently filled in nonaffiliated, mail-order or specialty pharmacies; the survey results show that between 24% and 40% of practices rated their experience with clinical support services provided by specialty or mail-order pharmacy as “poor.”
Commenting on this finding, the researchers noted, “It is disappointing to see significantly few excellent or good ratings, especially considering the categories being graded for performance included patient drug education, adherence oversight, timely refills, adverse effects, and adverse event management.”
The researchers concluded the report by saying, “As science stretches into the 21st century, it will be important to add new metrics to the NPB to raise awareness of new opportunities (and challenges) in operating a fiscally responsible practice so that patients have a refuge for treatment and healing.”
Reference
- Balch C, Ogle JD, Lenese JL. The National Practice Benchmark for oncology: 2015 report for 2014 data. J Oncol Pract. 2016;12:e437-e475.