ECG Management Consultants

The financial, strategic, and clinical importance of developing a comprehensive cancer program is undisputed. And yet the capital commitment to bring all the pieces of the care continuum together in a single location can be cost-prohibitive. Are virtual cancer centers a solution? This presentation explores a variety of strategies, including tumor conferences, focal sites of expertise, and EMRs, that have been used to successfully integrate clinical services across a regional network.

Over the last several years, a remarkable number of private medical oncology groups have shifted to hospital and/or health system employment. Given the critical importance of the oncology service line, many hospitals and health systems have either acquired a group of medical oncologists or are likely to do so in the near future. While the acquisition of a medical oncology practice offers a variety of benefits to a hospital and/or health system, the expected financial results are frequently not attained. This article explores the issues hospitals and health systems must address to ensure the strong financial performance of the acquired practice.

Most oncology strategic plans are focused on how best to integrate and coordinate services across the various providers involved in a patient’s care. While the planning efforts can be challenging, the real work (and payoff) is related to successfully implementing the plan. This session draws on the recent experiences of a five-hospital health system that decided to aggressively pursue developing an integrated cancer program in early 2011. Tangible implementation examples are provided from the case study health system and other organizations regarding critical success factors, lessons learned, and what to expect in terms of resources and timing.

For hospitals and oncologists alike, alignment can be an intimidating concept, particularly given the unique revenue streams associated with oncology services (e.g., infusion administration, radiation oncology treatments). However, an increasing number of organizations are pursuing stronger affiliations in an effort to better coordinate care, improve access, and ensure the long-term financial viability of oncology services. While physician employment has received much of the recent press, the Professional Services Agreement (PSA) has gained prevalence as a mutually beneficial, high-integration alignment strategy. This article highlights the basic features and benefits of a PSA model for oncology services and offers an explanation for this model’s increasing popularity.

The health care payment landscape continues to change rapidly for oncology practices and service lines, as current reimbursement declines; payors move from fee-for-service to value-based purchasing; and providers are increasingly at risk for the quality and cost of services they perform. With market forces driving clinical integration and consolidation, oncology providers are also being confronted with opportunities to participate in an array of new delivery arrangements, including ACOs, Primary Care Medical Homes, Integrated Delivery Systems and limited/exclusive provider networks. This session will explore the organizational options available to oncology groups and hospital service lines to position themselves for future success in this evolving health care environment. Strategic options examined include: clinical affiliation arrangements, oncology medical homes, oncology super groups and super IPAs, contracting with ACOs, PCMHs and integrated delivery systems, private equity joint venture structures, hospital service line models, practice acquisition and employment transactions.

Continual reductions in payments to medical oncology practices are driving physicians to seek the shelter of hospital employment. For the unprepared health system, this trend raises a variety of questions related to the strategic and economic value of such an affiliation. However, as described in this article, the acquisition of medical oncologists can offer significant strategic value to an organization. In addition, the economic realities of a hospital-based practice can mean stability and security for an otherwise struggling practice and service line.

Even with the best technology, facilities, location, physician relationships, and clinical support staff as well as high quality marks, your cancer center may still fall significantly short of reaching its potential in the long term if your patients’ treatment planning and therapy is not provided through a multidisciplinary team approach. Implementing and sustaining this approach to care can be extremely challenging depending on several factors, such as the size and scope of the cancer program, competitive landscape of the market, and organizational structure of the center, including hospital/physician relationships. This article demonstrates that centers and programs which adopt a multidisciplinary approach to care will ultimately prevail in this era, when patients know and demand more.

Cancer care providers, both in the hospital and practice setting, are in the midst of uncharted and stormy waters. Few would disagree about the need for the strategic alignment of hospitals, physicians, and related cancer services. Although most understand that the next five years will see industry-wide transitions to new cancer care delivery models, there is much debate on how best to achieve strategic, economic, and operational integration across multiple providers and sites of care. And since each market has different characteristics, one size does not fit all. The good news is that many options are available. The caveat: an effective integration strategy may entail changes in the structure and culture of the oncology community. This article discusses options for closer alignment between physicians and hospitals and describes the required steps for a successful transaction.

The acceleration of physician employment and alignment have led hospital executives to evaluate different service line strategies to enhance brand awareness and improve return on investment (ROI). In some service lines, such as cardiac and cancer, national accreditation and the achievement of well-known designations are important tools in positioning the service line and creating market differentiation. This presentation explores how to choose the right accreditation target for your service line, as well as the differences between certain accreditations/designations in terms of scope, financial investment, and program requirements.