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2017 Fee Schedule Reimbursement Analysis

In November 2016, the Centers for Medicare & Medicaid Service (CMS) released the 2017 final Medicare Physician Fee Schedule (MPFS) and Hospital Outpatient Prospective Payment System (HOPPS). As a yearly exercise, Oncology Solutions analyzes the fee schedules with a focus on radiation therapy and medical oncology to identify reimbursement changes that may affect cancer care providers. With more than 60%…

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Key Components of Patient Experience in the Oncology Setting

What is patient experience? Patient experience is defined as the “the sum of all interactions, shaped by an organization’s culture, that influence patient perceptions across the continuum of care.”1 More than cleanliness, quiet at night, or transitions in care, surveys show that patient experience is mainly affected by communication. In fact, over 50 percent of the Hospital Consumer Assessment of Healthcare Providers…

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Implementing Disease-Specific Clinical Performance Groups

Disease-Specific Clinical Performance Groups High-quality, patient-centered cancer care is highly dependent upon coordination of multiple specialties, including surgery, radiation oncology, medical oncology, pathology, radiology, and other ancillary staff. Equally important is the timely and consistent exchange of clinical information among the care team. Multidisciplinary care teams or Disease-Specific Clinical Performance Groups (CPGs) create a structure for cancer care providers to…

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What You Need to Know About Value-Based Payment in Oncology

In April 2015, Congress passed the Medicare Access and CHIP Reauthorization Act (MACRA). The law most famously repealed the Sustainable Growth Rate (SGR), ending the annual showdown over payment cuts to Medicare providers. MACRA also included ambitious reforms to the payment model with the introduction of two models to drive value-based payment to physicians: the Merit-Based Incentive Payment System (MIPS) and advanced…

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Developing an Oncology IT Strategy

Cancer has become a disease characterized by its data. Insurance companies demand cost and utilization data, searching for a meaningful way to optimize value. Patients request test results, lab values, and physician notes, seeking to become shared decision-makers in their care. Researchers, pharmaceutical manufacturers, and others seek clinical data in an effort to further our biological understanding of the disease…

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Patient Navigation Metrics

Patient navigation programs have achieved more traction over the last several years, including the release of the 2013 ONS Nurse Navigator Core Competencies and the 2012 Commission on Cancer (CoC) Standard 3.1, Patient Navigation Process. While these guidelines and standards have provided cancer programs with additional justification to support the navigator role, it is incredibly important for managers and administrators…

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Strategic Planning: A Roadmap to Follow to Ensure a Successful Oncology Service Line

Oncology defies the norm for most hospital business – existing primarily in the outpatient setting, spanning multiple departments – and requires high capital investment, including spending for a range of supportive care services critical for its population. Many hospitals also find it challenging to clearly track the flow of oncology funds across multiple departments and disciplines. Yet for successful program growth, it is important that…

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Value-Based Strategic Planning Necessary for 2020 Oncology Eco-System

The shift toward value-based care is swiftly realigning compensation for providers, placing a renewed emphasis on higher quality services at lower costs. At the same time, the industry is seeing trilateral movement from hospital-created health exchanges, employers and insurers toward narrower networks in order to maximize reimbursements and reduce costs.1 As these dynamics continue to evolve, hospitals and oncologists cannot rely…

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Delivering “Value” in Cancer Care

Value is something the consumer expects in the marketplace, where demanding a high quality product at a low cost is common practice. However, healthcare has historically not been held to a similar standard as other industries when delivering on this demand. Driven by recent pay-for-performance efforts, the need for this “norm” to change has the attention of patients, providers and…

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