- 4 takeaways for cancer programs from the 2019 HOPPS final rule and HHS announcements
October and November have been action-packed. In the span of two weeks, CMS released its final payment rule for hospital outpatient departments, and HHS announced mandatory payment reform pilots for Part B drug pricing and radiation oncology. Find our biggest takeaways for cancer programs here. Read the post
- Catching up with CAR T: How centers are building out capabilities and struggling to get reimbursed
When FDA approved two CAR T-cell therapies last year, it caused a groundswell of excitement across the country—but many questions remain around implementation and reimbursement. Keep reading to learn how one leading cancer center has reorganized its services to improve care for immunotherapy patients and how barriers to CAR T reimbursement are raising concerns about access. Read the post
- Your guide to oncology payment reform pilots
We've seen payers and providers increasingly interested in experimenting with oncology payment models over the past few years. To assist cancer programs that are exploring alternative payments or just want to stay on top of this trend, we've provided examples and links to additional information below. Read the post
- What you need to know about Medicare's physician supervision requirements
CMS' physician supervision requirements continue to be an area of uncertainty and confusion for many of our members. Here, we have compiled the most up-to-date information on physician supervision for chemotherapy and radiation therapy. Read the post
- An unintended side effect of cancer surgery: opioid dependence
Due to the severity of the disease and treatment, opioids are a critical part of many cancer patients' chronic pain treatment plans. However, cancer patients are often excluded from the national conversation about opioid prescribing—and a new study shows this omission may be harmful. Read more
- The new 4-letter word: Attribution in the Oncology Care Model—and how CMMI is responding
In conversations with Oncology Care Model (OCM) participants, we've heard consistent concerns about patient attribution, leading to it being dubbed the new four-letter word in cancer payment reform. Fortunately, the Center for Medicare and Medicaid Innovation (CMMI) has been responsive to stakeholders' feedback. Read the post
- Immunotherapy: What patients are hearing—and how to guide their expectations
With over two thousand new immunotherapy agents in clinical and pre-clinical development and the expanding adoption of newly approved treatments, such as CAR T-cell therapy, cancer patients are inundated with promises of new "miracle" drugs. While dramatic advancements in our understanding about cancer biology and treatment are touted in the media, research from Cardinal Health suggests that only 40% of oncologists see precision medicine as a game-changer, while 57% of oncologists believe that it's too soon to predict the long-term impact of precision medicine. Read the post
- 340B, drug administration packaging, and other changes impacting cancer programs in the HOPPS 2018 Final Rule
CMS has projected an overall increase in hospital outpatient department (HOPD) payments of 1.4% from 2017. However, a significant reduction in reimbursement of 340B drugs and drug packaging changes have left many oncology programs concerned about their revenues for the 2018 calendar year. Read on to learn more about these changes and other HOPPS updates impacting cancer care. Read the post
- Cone Health increases lung screening volumes nearly five-fold by expanding navigation
Navigators are an increasingly essential component of patient-centered cancer care. However, few track their direct impact on quality and financial outcomes. See how Cone Health Cancer Center-Alamance Regional in North Carolina made the case that adding a navigator will bring in an additional $750,000 per year. Read the post
- Your 4-step guide to prepare for a mandatory radiation oncology bundle
HHS Secretary Alex Azar recently announced CMS’ intention to launch a mandatory bundle for radiation oncology. We’ll have to wait for CMS to announce the details of the model, but, in the meantime, there are steps every cancer program should be taking to prepare. Read the post
Want more? Check out our archives for a deep dive in the key oncology news for 2018.
Catch up on our top oncology coverage in 2018—then come back for more key insights and commentary in 2019.