ECG was excited to participate in another outstanding ACCC conference at this year’s Annual Meeting & Cancer Center Business Summit (AMCCBS). The conference provided a forum for collaborative discussion across a range of critically important topics in cancer care business and policy. This year’s AMCCBS had a particularly strong emphasis on the future of healthcare. Here we’ve summarized ECG’s perspective on the key themes that emerged within this concept.
Difficult Payment and Policy Reality
The keynote session opened with a single figure on the big screen: $3.9 trillion. That number represents the 2019 projected cost of healthcare in the US—exorbitantly higher than all other developed countries and estimated to include more than one-third in waste. This big-picture view of healthcare’s cost issue, and oncology’s piece of the pie, set the stage for AMCCBS.
Our payment system is broken and unsustainable; on that point, there is little debate. Even at a time of partisan rancor, we’ve seen a bipartisan pledge to tackle healthcare costs (particularly drug costs, where oncology has become the problematic poster child). Moreover, the Trump administration has demonstrated a willingness to swiftly enact payment changes (e.g., step therapy for Medicare Advantage), as has Congress with expansion of meaningful cost-saving measures (e.g., site-neural payment policies). Dozens of evolving policies are anticipated to roll out over the next 18 months, likely reflecting proposals following Trump’s drug blueprint as well as patchwork cost-cutting solutions targeted at reducing drug spend.
In light of this, there was a louder call than ever at AMCCBS for providers to act. In the face of potential government mandates, the provider community must help drive policies that are sensible, meaningful, and realistic.
Sustaining Options for Community Oncology Practices
The implications of the evolving reimbursement landscape relate to our second theme: the increasing difficulty for community oncologists to remain independent. As traditional practice models in oncology are upended, new business structures and leading organizations will emerge. More so than in the past, this year’s conference had numerous sessions dedicated to partnership models or alignment strategies that can help sustain community oncology practices. Practice management companies—including long-standing leaders in this field (US Oncology Network) as well as newer entrants (American Oncology Network and One Oncology)—garnered vast attention from a standing room–only crowd that was eager to hear the about the benefits of joining such networks.
Interestingly enough, while practice management companies may offer a safe haven from a business perspective, they are not simply looking to maintain the status quo. The leadership panel collectively described well-suited candidates for their networks to be practices with a forward-thinking, performance improvement, and risk tolerance mind-set—illustrating that these companies are aiming to strategically reinvent themselves and be a part of the innovation within oncology.
Digital Health Revolution
Digital health was another hot topic, representing a broad and growing space that includes technologies such as mHealth, telehealth, personalized medicine, devices/wearables/sensors, and digital therapeutics (e.g., AI-assisted image analysis, CRISPR-engineered CAR T-cell therapy). However, while digitized information is increasingly being used to improve healthcare delivery, we still have a lot to learn about the value and practicality of deploying these technologies in the day-to-day lives of patients—especially for the most vulnerable populations, such as cancer patients. Many barriers still exist (e.g., lack of portable and transparent data), and the impact of digital technologies on health services is more reactive than proactive. Nonetheless, providers are making headway to implement and promote innovative practices. Anticipate digital health to be a mainstay topic for the foreseeable future, especially as the provider community learns to see technology as a friend and not a foe.
Patients as Consumers
Finally, it wouldn’t be a healthcare conference in 2019 without a focus on two of the industry’s most top-of-mind themes: the growing age of healthcare consumerism and the incursion of nontraditional, consumer-centric companies (Amazon, Google) into the healthcare space. The proactive discussion among providers around payment reform, care transformation, and business model strategies is all necessary, because companies like Haven will continue to drive significant change in healthcare. Oncology providers need to have strong strategies in place around their patients’ most desired attributes: a seamlessly coordinated care experience; treatment options that are affordable and personalized; and data that is easily movable and integrated.
Leading the Conversation
If there was one message that resonated throughout the discussions of policy changes, emerging business models, digital health, and evolving patient expectations, it was that the future of healthcare is being charted today. But who is charting that course? Leaving it in the hands of a divided federal government has its perils. And there are new, unfamiliar players in the game, bent on disruption. Not to mention patients, who are demanding more from providers than ever before.
What’s clear is that none of these stakeholders are content with the status quo—and oncology providers can’t be, either. Many 2019 AMCCBS attendees seemed to recognize the urgency of being proactive in a rapidly changing environment and are poised to steer the national conversation about healthcare in the right direction.