Lessons from 2016 for 2017: Oncology Practice Management Brings Value to Your Practice, and You Add Value to the Journal

Dawn Holcombe, MBA, FACMPE, ACHE
President, DGH Consulting, South Windsor, CT

As we enter 2017, I look back at the hot topics that Oncology Practice Management (OPM) covered in 2016. The majority of the articles and discussions centered on 3 main themes—patients, ongoing changes in healthcare, and practice management. In addition to the normal ongoing challenges of running a complex oncology practice, most practice administrators are also facing an ever-increasing array of new concerns and issues pressuring them and their oncology providers daily. By reviewing the hot issues that OPM covered in 2016, we can find some new directions charted for 2017.

Our Patients Keep Us Going

Patients are the reason we go to work every day. In 2016, the journal covered new directions in patient engagement, end-of-life care, survivorship care, palliative care, integrative oncology, and financial support. We also considered how clinical pathways are changing patient care for providers and for healthcare insurers, and how practices can become engaged in more quality programs, such as the “Choosing Wisely” program advocated by the American Society of Clinical Oncology and the American Society of Hematology.

Increasingly, oncology practices are being asked to guide, educate, support, and counsel patients to help them navigate their disease, as well as the treatment choices and the associated financial issues. New care management directions and obligations are expected of practices, and OPM will continue to showcase these obligations and opportunities for practices, as these challenges continue into 2017.

Healthcare Changes Are Constant

Changes in processes and clinical matters are the norm for practice managers today. In 2016, OPM showcased articles on new quality metrics for Medicare plans and oncology medical homes, physician compensation alignment with quality programs, and the impact of financial toxicity on patients’ quality of life. We addressed several changes related to oral oncolytic drugs, including drug-dispensing innovations, oral parity laws, and compliance technology.

Payment models continue to be one of the variables that will most dramatically affect oncology practices in the coming years. OPM authors covered information that practice administrators will need to know regarding oncology medical home payments; the Centers for Medicare & Medicaid Services (CMS) Oncology Care Model (OCM); the impact of payment-driven reductions on practices in the insurance co-ops created by the Affordable Care Act; and especially the looming effect of the incentives and penalties of the Medicare Access and CHIP Reauthorization Act (MACRA), including the Merit-Based Incentive Payment System and the Advanced Alternative Payment Models.

In addition to the public and private payer payment reforms, and the growing reliance on quality reporting and performance, oncology practices are being buffeted by hazardous drugs operational and regulatory compliance demands that are driven by the US Pharmacopeial (USP) pharmacy standards set forth in Chapter 797 (USP 797) and Chapter 800 (USP 800), which were reviewed in this journal in 2016 and will continue to be followed in 2017.

Practice Management

Practice management is the founding purpose of OPM, and there was no shortage of practice management issues to cover in 2016. Our authors looked at the shift in the site of infusion services, community practice challenges, biosimilars, practice benchmarks, practice consolidation and growth, and succession planning.

In addition, we looked at the details of complying with USP 797 and USP 800 standards, and managing medical liability. Furthermore, we offered technology solutions for communicating with cancer survivors and for adhering to oral cancer drugs.

CMS dominated the news with its launch of the OCM program; the transition to the International Classification of Diseases, Tenth Revision diagnosis codes; the unveiling of the MACRA program; and the Medicare Part B Drug Payment Model, which was canceled after significant objections were expressed by the oncology community. The year 2017 will most likely be full of as many transitions. Reporting, quality measures, performance, and regulatory compliance change on a daily basis.

Looking Ahead to 2017

I enjoy traveling and speaking with practice administrators from all over the country. We all love our work in oncology, despite the trials and tribulations that accompany it.

Many practice administrators tell me that they retain their copies of OPM and refer to them as the year progresses and nuances of the programs become evident, or comparisons or benchmarking become important for budget purposes.

Practice administrators appreciate having a resource such as OPM to turn to for updates and new and evolving information. We appreciate your support, enthusiasm, and contributions. Please stay engaged, and continue to share your stories and questions with us.

We welcome contributions from our practice administrators and other readers of OPM. I invite you to contact me anytime at This email address is being protected from spambots. You need JavaScript enabled to view it. with article ideas or suggestions, or if you are interested in contributing an article to the journal. Together, we will advance the practice of oncology management one month at a time.

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