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For Immediate Release: July 1, 2009
National Survey Spotlights Cancer Care Trends: Association of Community Cancer Centers Examines the Business Side of Hospital Cancer Care
Rockville, Md.—A newly released survey of community-based cancer programs by the Association of Community Cancer Centers (ACCC) suggests that the business side of cancer care is undergoing rapid evolution: Changing reimbursement; financial challenges; and rising costs for drugs, technology, and personnel challenge the ability of provider organizations to adapt.
“To gain insight into organizational strategies that may help the cancer care team adapt to the changes in the healthcare marketplace, as well as to identify trends in ambulatory cancer care, the Association of Community Cancer Centers initiated an annual survey of its membership,” said Christian Downs, JD, MHA, ACCC executive director.
Key findings include:
Consolidation is commonplace in oncology—and increasing. The most common type of consolidation is among physician oncology practices; around 30 percent of hospital cancer program respondents report an affiliation with physician oncology practices in the market area. Seventeen percent of hospital respondents report consolidation (merger, acquisition, affiliation) within the respondent’s program, another 15 percent report consolidation with another program in their primary market area. As for the next one to two years, 30 percent expect an affiliation with physician oncology practices and 18 percent with programs in their primary area.
Finances are healthy—maybe. Despite an economic downturn, most respondents (90 percent) characterize their cancer program’s financial status as good or very good. Just 4 percent report poor financial health. And yet, one out of three respondents reports that the cancer center is not able to track profit and loss. Hospitals, as primarily inpatient businesses, are often challenged to monitor and report on outpatient services, such as outpatient chemotherapy infusions. Meeting this challenge will be critical going forward.
Orally administered anti-cancer agents are not popular in cancer programs. Just 21 percent of programs dispense oral cancer drugs at the infusion center. These numbers will likely increase as more and more oral agents come to the market and patients demand their greater convenience. Hospitals are well-positioned, since they already have in-house pharmacies.
Most cancer programs rely heavily on private practice physicians. About one-half of hospital respondents have medical or hematologic oncologists who are in private practice, while a slightly lower number (46 percent) report medical or hematologic oncologists as paid employees of the hospital. As oncologists in private offices struggle with declining reimbursements and seek financial stability, many are opting for employment at hospitals. A major shift in site of care may loom ahead.
The survey, available online at www.accc-cancer.org, will provide ACCC with information to assist members in evaluating their organizations’ performance. The survey will be conducted annually for three years, and is a joint project between ACCC and Eli Lilly.
“Community-based cancer programs seem to be adapting to today’s difficult economic times,” said Mr. Downs. “They’re streamlining their cancer service line, cutting back on capital equipment, and hiring the most talented employees and providing them the environment they need to thrive.”
Today’s cancer programs confront increased demands for transparency and pressure to demonstrate value through operating performance, quality report cards, and outcomes. At the same time, they face declining reimbursements from both Medicare and private payers and a continuing physician and nursing workforce shortage.