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How your peers are deploying APs in their medical oncology clinics

November 30, 2016

    Advanced practitioners (APs) are an important member of medical oncology team, providing a variety of services as both independent providers and physician extenders.

    Last week, we discussed how APs can increase oncologists’ capacity—but that depends on how clinics use APs and if they’re practicing at top of license. Keep reading to see how medical oncology clinics across the country deploy APs.

    APs assigned to physician or clinic(s)

    According to our recent survey, the majority of clinics assign APs to a physician, a clinic, or across clinic sites. More than 40% of respondents assign APs to a specific physician.

    How advanced practitioners are assigned


    APs are tasked with a diverse set of responsibilities

    We also asked respondents to indicate which services (from a list of 20 responsibilities) their APs perform in the medical oncology clinic. Overall, APs are responsible for an average total of 7.9 different tasks.

    Providing symptom management and conducting follow-up visits are the two most common tasks performed by APs, with 94% of our respondents reporting that APs take on these roles. Other common responsibilities of APs include writing patient notes, providing infusion center supervision, supporting patients on oral chemotherapy, and assisting with new patient visits.

    Top 10 tasks assigned to APs

    Tasks assigned to APs Percent of respondents
    Provide symptom management 94%
    Conduct follow up 94%
    Dictate or write patient notes 79%
    Provide infusion center supervision 56%
    Support patients on oral chemotherapy 56%
    Assist with new patient visits 54%
    Writing admissions and discharge summaries 48%
    Write chemo orders on behalf of a physician 47%
    Manage survivorship clinic 47%
    Perform routine procedures 48%

    This data reveals that many APs aren’t practicing to the full extent of their education and training. For instance, over three-quarters of respondents say APs spend time dictating or writing patient notes, while only 46% of medical oncology clinics have APs performing routine procedures.

    Although state regulations and payer policies differ locally, giving APs the opportunity to provide top-of-license care has the potential to expand clinic capacity.

    Direct billing is most common for AP services

    Another question we commonly receive is how APs bill for their services. We found that more than half of medical oncology clinics bill directly, but shared billing and incident-to-billing are also quite common. 22% of institutions reported employing a variety of the above billing methods.

    How institutions bill for the work of APs


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