Insights From the Cancer Center Business Summit: Preparing for the Future

We are all aware of the rapid pace at which the delivery of cancer care is changing. Implementation of major provisions of the Affordable Care Act are underway, with the Center for Medicare and Medicaid Services (CMS) issuing multiple regulations that will determine how care is organized, delivered, and compensated. Providers are on a seemingly constant treadmill, scrambling to keep up. There are also important deadlines looming for participation in CMS reporting programs, including the Physician Quality Reporting System (PQRS), meaningful use, and the introduction of the value-based payments. Of course, perennial anxiety over the sustainable growth rate continues. On January 1, 2013, Congress once again stepped in to avoid these cuts by including in the so-called fiscal cliff bill a provision that patched the SGR for one year. One bright note: the legislation required the Administration to establish a process for qualifying clinical registries as a means of complying with PQRS reporting requirements. This opens the door, not only for more meaningful measurement in oncology; it also could allow participants in the ASCO Quality Oncology Program Inititiative (QOPI) to use their work to satisfy PQRS requirements. With unprecedented demands on physician time, how can a busy oncologist hope to stay current with this pace of change? Professional societies like ASCO are a rich source of information that can make a difference. Our education programs and journals are important tools for meeting the challenges ahead. This issue of Journal of Oncology Practice brings together these two vehicles: a collection of articles authored by speakers and panelists who attended the 2012 Cancer Center Business Summit (CCBS). In October 2012, I posted a blog on ASCO Connection describing my experience at the CCBS. I noted that the Summit emphasized the significant challenges facing oncology, but it also left room for hope. Practices are feeling the squeeze of shrinking reimbursement, but they are adapting. Most of us would agree that the future of community cancer care remains uncertain, but, like many others present at the meeting, I left feeling excited about our field and even about the future. Practices are implementing innovative solutions to better coordinate care, contain cost, and become more efficient. Meetings like this are an opportunity for us to share these experiences and to seize opportunity. The CCBS was founded in 2007 and is a sponsor-supported national “think tank” that focuses on best business models and practices for community oncology. The Summit brings together key cancer care stakeholders with business, finance, and legal thought leaders to explore the future course for community oncology in our rapidly evolving health care system. Now in its seventh year, the Summit is recognized as a leading resource for the business of community oncology. It annually conducts a one-and-a-half day conference that includes original research on topics of current interest; a panel on innovative provider initiatives; a panel on payment pilot projects; a Washington update; case studies of strategic options and best business practices; and expert panels on the key business, financial, and regulatory issues facing community cancer care today. The Summit is planned by a national Advisory Board drawn from diverse segments of the community oncology sector. The Summit offers unprecedented education and networking opportunities in the complex world of practice management. Oncology may present some of the biggest challenges in this arena. Recognizing this—and the need it fills for our members—ASCO joined the CCBS as an official sponsor in 2012 and will continue in that role in 2013. This issue of JOP touches on concerns I hear every day from the practicing community: the role of private payers in helping to contain the costs of cancer care; practical issues in palliative care; how payers are collaborating with providers to implement cost-management and delivery models; the oncology medical home and compensation structure within that context; practical details related to moving from private practice to hospital-based practice; effects of the Affordable Care Act's “essential health benefits” on oncology coverage; and an overview of the 340B Program. These are all reports relating to or stemming from the Summit, and they all provide insight I hope will be helpful to you.