From the Editor

As we enter a new decade, we are seeing a widening gap between those who provide care and those who pay for care. This growing divergence is evidenced, in part, by the different sources being used for clinical pathways and authorized coverage for payment. Initially, payers tend to consider national guidelines, such as the National Comprehensive Cancer Network Clinical Practice Guidelines in Oncology, as a starting point for acceptable treatment choices made by physicians, but then refer to internal policies or external vendors to narrow the parameters required for clinical and payment coverage. Read Article ›

Still waters run deep. While cancer centers and practices continue to navigate the highly visible challenges of operations, reimbursement, and competition, as well as Medicare and private payer relationships, other potential hazards may be lurking just out of sight. This article discusses 3 areas where activity in your local market could suddenly surface and completely change the environment in which you provide care. Read Article ›

Although our top priority is to provide high-quality care, we often encounter barriers and hurdles that can affect where, when, and how we interact with our patients and staff. Given the increased focus on the acquisition, handling, preparation, and administration of drugs in medical practices—especially oncology practices—we are now being challenged with existing and emerging restrictions and expectations, which are continually in a state of transition. In this article, I want to share 3 important tips that will help you be more prepared and protected this fall. Read Article ›

Medical practices and hospital centers across the United States are facing important choices that will determine their fiscal and physical viability moving into 2020. Not only is the impetus behind these required changes unclear, many feel that there is a lack of purpose and justification for them, which has resulted in mounting frustration. Read Article ›

Healthcare is a highly competitive industry that continues to undergo significant changes, including an increase in digital technologies and other innovations that offer patients new ways to customize their care and find more convenient options for health services tailored to their needs, lifestyles, and finances. As these advancements usher in a new area of healthcare, we need to ask ourselves, “Are we missing the boat?” “Are we about to lose the battle for patient healthcare in the same way that taxis have gradually lost their market for the traveling public to on-demand transportation services such as Uber?” Read Article ›

Pharmacy standards will be applied to medical practices, regardless of whether they have a pharmacy licensed with their state Board of Pharmacy. Read Article ›

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? Read Article ›

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 Article ›



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