OBR Daily Commentary

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Vantage Oncology’s 50 Centers and More Than 350 Affiliated Physicians Join The US Oncology Network

(Yahoo! Finance) Jan 26, 2017 - The US Oncology Network announced today, as part of McKesson Specialty Health’s ongoing integration with Vantage Oncology, that 50 centers in 13 states and more than 350 affiliated physicians have joined The Network.

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Thomas Marsland, MD (Posted: January 30, 2017)

quotesSo having the advantage of 35 years of practice has allowed me to see many different models of practice. I have been in a true multispecialty group, a small single specialty group, large corporate models (as being described), a large single specialty practice, and a large cancer focused multidisciplinary practice. The article leads off with a comment about "independent community based providers." My question is: "Is that model viable going forward?" Having watched my market evolve I am very skeptical that even with the power of a large national company that "independent community providers" will be around in the future. Certainly in some markets - yes. However what I have seen is the large hospitals form their own healthcare systems playing hard ball in a way that either you join them or they go out and bring in their own (non independent) oncologists. At best I see community docs as part of carved out joint venture with a local system (all politics are local as is healthcare delivery). Today even with a multidisciplinary cancer focused practice it is hard to provide all of the services: cancer prevention, diagnosis, treatment and support required. Many other specialties and supportive care providers are needed. Hospitals and "systems" are not going to let that business go. As one who grew up in the "buy and bill" days, I am saddened by these changes but we have to adapt and be involved for our patients and ourselves.quotes

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Ryan Confronted By Cancer Patient Who Says ObamaCare Saved His Life

(The Hill) Jan 12, 2017 - Paul Ryan faced some tough questions from audience members at a CNN town hall Thursday night, starting with a cancer patient who said ObamaCare saved his life.

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Thomas Marsland, MD (Posted: January 23, 2017)

quotesFor every ying there is a yang...... so the ACA may well save some lives but the other side of the coin is also true. I believe that all the added rules and regulations put on us by the ACA often results in treatment delays that could cause lives being lost. The prior auths and pre certs that come the all the low cost Obama care plans certainly cause treatment delays. the degree of ridiculousness cannot be exaggerated.... I actually had to get authorization for a urine analysis the other day. Gosh I must be getting rich ordering UA's. On a more somber note I actually had a patient with a hepatoma that with all the road block thrown up by the insurance company actually took 5 months before she received any treatments at all. Her prognosis was dismal to start but the 5 month delay certainly didn't help. It actually got so bad that I had to go the state insurance commissioner before we had any movement. So as I said just be careful there are always two sides to every story. quotes

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Association of Community Cancer Centers’ 2016 Survey Finds Cancer Drug Costs Remain the Most Critical Challenge to Care

(ACCC) Jan 5, 2017 - As more cost pressures are placed on the healthcare system and the transition to value-based care gains momentum, the Association of Community Cancer Centers (ACCC) seventh annual Trends in Cancer Programs survey reveals critical challenges and emerging trends at U.S. cancer programs.

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Thomas Marsland, MD (Posted: January 10, 2017)

quotesWell its a new year but still the same problems. The cost of cancer drugs really is a huge problem. I am glad the misdirected ASP demo project was nixed but the price of new therapies is still an issue that needs to be addressed. We all talk about value and indeed we have made significant strides in helping to define value but the second piece to the value equation is affordability. Even if new agent has value, can we afford it? Not everyone can drive a Rolls. My biggest concern as we move into newer payment models is that they will include bundling and episodes of care that put practices at risk and may force "me" to tell a patient that they cannot have a new treatment because my practice cannot afford it. It makes one wonder if a NICE type program could ever happen here. I certainly would prefer to have the backing of some outside organization that has made the decision that a specific treatment is not "affordable" rather than it being solely based in my specific practice economics. The article also make some very good comments on how much of what we do is still not adequately recognized as valuable in many of the newer compensation models. We need to be sure that future payments do adequately cover our cost for regulatory reporting, care coordination, increased patient access, and many of the other increased services needed to provide a good medical oncology "home".quotes

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Meet the Editorial Board

Community Oncology
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Dean Gesme, MD

FACP FACPE FASCO President, Minnesota Oncology...

Breast Cancer
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Debu Tripathy, MD

Professor and Chair, Department of Breast Medical Oncol...

Lung Cancer
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H. Jack West, MD

Medical Director, Thoracic Oncology Program, Swedish Ca...

Gastrointestinal Cancers
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Howard S. Hochster, MD

Associate Cancer Center Director, Yale Cancer Center P...

Radiation Oncology
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Howard Sandler, MD, MS, FASTRO

Professor and Chair, Department of Radiation Oncology...

Community Oncology
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Jeff Patton, M.D.

CEO Tennessee Oncology...

Precision Medicine Section Editor
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Jennifer Levin Carter, MD, MPH

Chief Medical Officer and Founder, N-of-One...

Health Policy
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Joseph Bailes, MD

National Health Policy Expert...

Financial Sector
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Michael G. King Jr.

Managing Director and Senior Biotechnology Analyst...

Gastrointestinal Cancers
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Richard Goldberg, MD

Professor and Physician-in-Chief of the Ohios State Uni...

Editor-In-Chief
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Robert A. Figlin, MD., FACP

Professor and Director, Division of Hematology Oncology...

Community Oncology
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Thomas Marsland, MD

Vice President Integrated Community Oncology Network ...

Community Oncology
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William Harwin MD

Florida Cancer Specialists President and Managing Part...

Health Policy
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William McGivney, PhD

National Health Policy Expert...

Payer
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Winston Wong, PharmD

President, W-Squared Group...