[Show abstract][Hide abstract] ABSTRACT: The National Practice Benchmark (NPB) is a unique tool to measure oncology practices against others across the country in a way that allows meaningful comparisons despite differences in practice size or setting. In today's economic environment every oncology practice, regardless of business structure or affiliation, should be able to produce, monitor, and benchmark basic metrics to meet current business pressures for increased efficiency and efficacy of care. Although we recognize that the NPB survey results do not capture the experience of all oncology practices, practices that can and do participate demonstrate exceptional managerial capability, and this year those practices are recognized for their participation. In this report, we continue to emphasize the methodology introduced last year in which we reported medical revenue net of the cost of the drugs as net medical revenue for the hematology/oncology product line. The effect of this is to capture only the gross margin attributable to drugs as revenue. New this year, we introduce six measures of clinical data density and expand the radiation oncology benchmarks.
Preview · Article · Nov 2014 · Journal of Oncology Practice
[Show abstract][Hide abstract] ABSTRACT: In this, the seventh iteration of the National Practice Benchmark, the authors made significant changes in the approach and analysis of the survey, including restructuring and shortening the survey instrument to facilitate the participation of hospital and academic oncology practices, in recognition of the ongoing changes in the oncology industry.
Preview · Article · Nov 2012 · Journal of Oncology Practice
[Show abstract][Hide abstract] ABSTRACT: In 2011, we made predictions on the basis of data from the National Practice Benchmark (NPB) reports from 2005 through 2010. With the new 2011 data in hand, we have revised last year's predictions and projected for the next 3 years. In addition, we make some new predictions that will be tracked in future benchmarking surveys. We also outline a conceptual framework for contemplating these data based on an ecological model of the oncology delivery system. The 2011 NPB data are consistent with last year's prediction of a decrease in the operating margins necessary to sustain a community oncology practice. With the new data in, we now predict these reductions to occur more slowly than previously forecast. We note an ease to the squeeze observed in last year's trend analysis, which will allow more time for practices to adapt their business models for survival and offer the best of these practices an opportunity to invest earnings into operations to prepare for the inevitable shift away from historic payment methodology for clinical service. This year, survey respondents reported changes in business structure, first measured in the 2010 data, indicating an increase in the percentage of respondents who believe that change is coming soon, but the majority still have confidence in the viability of their existing business structure. Although oncology practices are in for a bumpy ride, things are looking less dire this year for practices participating in our survey.
Preview · Article · Sep 2012 · Journal of Oncology Practice
[Show abstract][Hide abstract] ABSTRACT: ASCO projects a shortfall of oncologists in the next decade. The study was designed to address the workforce shortage by exploring collaborative oncology practice models that include nonphysician practitioners (NPPs).
ASCO contracted with Oncology Metrics, a division of Altos Solutions, to conduct a national survey of NPP integration and identify collaborative practice models and services provided by NPPs, as the first phase of the ASCO Study of Collaborative Practice Arrangements. Results of the national survey were used to identify practices for the next phase, in which selected practices participated in a more detailed data survey and satisfaction surveys. Focus groups or interviews were conducted with NPPs to collect additional subjective information to inform the project.
The incident-to practice model was the predominant model. Satisfaction was universally high for patients and generally high for physicians and NPPs. In virtually all cases (98%), patients recognized they were seeing an NPP rather than a physician. Practices in which the NPP worked with all practice physicians showed significantly higher productivity than those practices in which the NPP worked exclusively with a specific physician or group of physicians.
The use of NPPs in oncology practices increases productivity for the practice and provides high physician and NPP satisfaction. Patients were aware when care was provided by an NPP and were very satisfied with all aspects of the collaborative care that they received. The integration of nonphysician practitioners into oncology practice offers a reliable means to address increased demand for oncology services without adding physicians.
Preview · Article · Sep 2011 · Journal of Oncology Practice
[Show abstract][Hide abstract] ABSTRACT: Oncology Metrics, a division of Altos Solutions, has been conducting organized surveys of practicing oncologists since 2005. In this article, we present data that represent trends in community oncology practice over a 6-year period, 2005 to 2010, and make projections on the basis of these data. Over the next 3 years, operating margins will continue to decrease, gains in business and clinical operating efficiencies will slow, and labor costs will rise. The cost of drugs provided to patients is also increasing while the amount above cost that is being reimbursed continues a slow decline. The gap between practice costs and practice revenue will continue to narrow, and as this occurs, community oncology practices will find it difficult to maintain their current business models.
Preview · Article · Sep 2011 · Journal of Oncology Practice
[Show abstract][Hide abstract] ABSTRACT: Across the country, there are many examples of oncology practices struggling financially, merging with other organizations, and even closing, but we believe the data presented here indicate that the business operation of oncology practice is becoming more mature, more efficient, and more self-aware. This is evidenced by the improvement in several of the metrics presented here and, to a small extent, by the number of survey participants who were willing to share information and the quality of data that they were able to provide. This indicates a broader understanding of the use and importance of peer-to-peer benchmarking. Several years ago, we introduced the concept of a standard HemOnc and defined it as a medical oncology or HemOnc physician who sees 350 new patients per year. At the time when we proposed that convention, there were many who considered 350 an extremely high number. In this survey, that standard has risen to 389-quite a remarkable gain in productivity. Knowledge of objective standards drives gains in productivity in an environment in which such gains are rewarded. Just as computerized practice management systems have streamlined the processing and measurement of billing and collection operations, so too will the adoption of electronic medical records allow for similar improvements in other aspects of the oncology practice. Health care reform seeks to promote measurement of clinical activity-the way similar patients are treated and the outcomes of that treatment. When we are able to report clinical benchmarks, we can reasonably expect gains in quality and efficiency. Then we will be truly advancing our abilities to take care of individual patients and sustaining our economic capacity to take better care of more people living with cancer. The 2011 National Practice Benchmark survey (on 2010 data) opened in February, and findings will be published later this year. For additional information about the National Practice Benchmark, please e-mail [email protected]
Preview · Article · Mar 2011 · Journal of Oncology Practice
[Show abstract][Hide abstract] ABSTRACT: Oncology practices continue to experience economic pressures as costs rise, numbers of patients increase, and reimbursements from payers remain flat or decrease. Many practices have responded to these challenges by examining business processes and making changes to improve efficiency and decrease costs. The National Practice Benchmark is a national survey of community oncology practices that provides data for practices to use in managing today's challenging practice environment.
Oncology practices were invited to participate in an online benchmarking survey. One hundred eighty-nine practices from 44 states responded to the survey, and demographic, operational, and financial data were collected for calendar year 2009 or the most recently completed fiscal year.
Data from 2009 were compiled and compared with previously collected 2007 and 2008 data. The data reveal that total revenue has increased by approximately 6% per year over this 3-year period. During the same period, however, cost of drugs increased dramatically: 13.5% increase from 2007 to 2008 and 16% from 2008 to 2009. Total practice expense increased at virtually the same level as drug costs in 2008 and was flat for 2009.
Survey results indicate an overall lowering of practice expenses even as cost of drugs continues to rise, and are consistent with the slight increase in the number of new patients per full-time equivalent hematology/oncology physician. These measures indicate an overall increase in service delivery efficiency and adaptation by many practices to the changing practice environment.
No preview · Article · Sep 2010 · Journal of Oncology Practice
[Show abstract][Hide abstract] ABSTRACT: Purpose: Oncology practices are experiencing increasing economic pressures as costs rise, the number of patients needing services increases, and reimbursements from payers remain flat or decrease. Many practices have responded to these challenges by examining business processes and making changes to improve efficiency and decrease costs. Benchmarking is a valuable tool for such practice improvement. This article presents results from the 2009 National Practice Benchmark. Methods: Oncology practices were invited to participate in an online benchmarking survey. Two hundred eight practices from 41 states responded to the survey, and demographic, operational, and financial data were collected for calendar year 2008 or the most recent fiscal year. Results: Data from 2008 were compared with previously collected 2007 data. The 2008 data show fewer small practices (with one to three full-time equivalent physicians) reporting and fewer sites of clinical service per practice. The most compelling data presented show that total practice expense increased 15% from 2007 to 2008, whereas total collected revenue increased by only 6%. Clearly there are fewer dollars available to support clinical operations. Conclusion: These results highlight some of the challenges faced by oncology practices today. Some practices have responded to these challenges by cutting costs (and sometimes eliminating services) and improving efficiency. For many practices, continued business management improvements will be necessary to provide adequate compensation for physician partners to warrant acceptance of the business risks associated with practice ownership and operation. In practices in which these improvements do not materialize, physicians will either close their practices and exit the field or seek other practice arrangements to continue to provide oncology services at less personal risk.
Preview · Article · Sep 2009 · Journal of Oncology Practice
[Show abstract][Hide abstract] ABSTRACT: Long-term trends in the cost of pharmaceutical goods purchased by community oncology practices seem to have dramatically changed in 2007, potentially ending an era of practice growth built on the economic engine of in-office chemotherapy provision.
Preview · Article · Jul 2008 · Journal of Oncology Practice
[Show abstract][Hide abstract] ABSTRACT: The prolonged, ubiquitous use of practice management systems and the more recent use of electronic medical record systems in oncology have led to the accumulation of significant repositories of financial, operational, and clinical data. This article examines the use of these data to provide peer-to-peer benchmarking of operational and financial information and series of data-driven national indices of clinical treatment patterns in oncology. Although not directly measure of the presence or absence of managerial excellence or clinical quality outcomes, these benchmarks and indices do measure the degree to which processes in place may be beneficial to higher quality management of clinical, financial, and operational outcomes.
Full-text · Article · Mar 2008 · Community Oncology
[Show abstract][Hide abstract] ABSTRACT: The Medicare Modernization Act (MMA 2003) introduced significant reimbursement changes to medical oncology practices. In response, practices have begun to evaluate and monitor practice finances more closely and to implement changes to improve practice efficiency. Benchmarking is an important tool for practices to use in this context, but benchmarking standards are difficult to identify. The authors present financial results from a 2006 survey of office-based oncology practices and provide tools for oncologists in all practices to use as they work to improve business processes.
No preview · Article · Apr 2007 · Community Oncology
[Show abstract][Hide abstract] ABSTRACT: Overview: The economic necessity imposed by the demo- graphic reality of the aging "Baby Boom" generation in the United States is forcing our society to recognize and ad- dress the unsustainable growth in spending for health-care services. The changes imposed by this reality will affect all of medicine, and oncology, because it affects so many older people, and will be sooner affected than other areas of medicine. As both care givers and business managers, the first, most productive improvements that can be made at the business-entity level will deliver measurable improvements in clinical, operational, and financial terms simultaneously. The presentation on which this article is based outlines these domains, highlights their importance and interdepen- dence, and then offers one important opportunity from each domain. This article will help readers to identify successful models to manage increased drug costs and declining drug reimbursements in oncology, describe the Competitive Ac- quisition Program for part B drugs that will be implemented in 2006, and discuss the Demonstration project in 2006 and use of midlevel providers.