OBR Daily Commentary

forumImage

ASCO Applauds Congress for Making MACRA Work, Committing to Cancer Research in Latest Budget Bill

(ASCO in Action) Feb 9, 2018 - “The American Society of Clinical Oncology (ASCO) commends Congress for passing a continuing resolution that includes an important correction to the Merit-based Incentive Payment System.”

Read Article arrow

Thomas Marsland, MD (Posted: February 12, 2018)

quotesYEA!!! Occasionally Congress can get it right. Hey, even a blind squirrel can find an acorn now and then........quotes

Add Comment 1 Comment
forumImage

Is Federal Policy Really To Blame For The High Cost Of Cancer Care?

(Forbes) Feb 8, 2018 - Although cancer care is increasingly becoming hospital or health system based, merger mania in oncology is probably not driven primarily as a way for hospitals to gain access to discounted drugs. Broader forces are at play.

Read Article arrow

Thomas Marsland, MD (Posted: February 08, 2018)

quotesThere is a lot beneath the surface in this report. Clearly the major factor in the growth of hospital practices is the 340B program but it is clearly not the only factor. The point is that whether an institution participated before or after 2010, those 340B facilities have a definite competitive advantage over community private practice. Hospitals, whether 340B or not, also have a higher compensation for the exact same service provided under the OPPS compared to the physician fee schedule that private practices bill under. Many also charge a facility fee that private offices cannot. In addition to the expanded revenues afforded hospital centered practices, the bottom line revenues in private practices has deteriorated due to ASP and the multitude of new rules, regs, and other requirements foisted on private practice by the payer communities. The shrinking revenue in private practice has driven doctors to the hospital settings where doctor compensation may be better and there is less hassle with the day to day running of a practice. So as the author suggested it is not solely due to 340B issues that we are seeing the death of private practice but it surely is one of the major drivers. Will be interesting to see how the new reduced payments under the 340B program effect this migration. quotes

Add Comment 1 Comment
forumImage

Here’s What We Actually Know About The Amazon, Berkshire And J.P. Morgan Health Initiative (Hint: Very Little)

(MarketWatch) Feb 5, 2018 - Health experts say many have tackled rising health care costs, with limited results.

Read Article arrow

Thomas Marsland, MD (Posted: February 06, 2018)

quotesSo maybe they really are smarter than the rest of us and can provide better care at a lower cost. Certainly these are highly successful, powerful companies and if they really leverage their strengths and resources perhaps they will be able to accomplish their goals. I'm not sure that the "free from profit making" is going to be the answer since there still will be huge costs in providing care. They claim that with the number of employees they can develop "cost effective ways" to deliver care. Gee, the rest of us have never thought of that....Clearly cost and value are hard to define and have different meanings to different stakeholders. As we all struggle to provide more cost effective care I am struct by how much harder it is to deliver good care because of all the rules, regulations, and requirements that delay access to the care patients truly need. One step in the right direction these companies are exploring is to get rid of the hugely expensive middle man, the payer. Payers have large bloated overhead that increase cost of care tremendously. If these successful companies can bring the ability to coordinate care through more efficient information systems which they have used successfully in their other operations, perhaps this will result in a reduction in cost without loss of quality care. If their systems can eliminate many of the problems experienced by doctors and patients who struggle daily with non inter-operative, inefficient information systems, that would certainly go a long ways towards obtaining all our goals of a better health delivery system. So I guess we will find out. quotes

Add Comment 2 Comment

Meet the Editorial Board

Community Oncology
member photo
Dean Gesme, MD

FACP FACPE FASCO President, Minnesota Oncology...

Breast Cancer
member photo
Debu Tripathy, MD

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

Lung Cancer
member photo
H. Jack West, MD

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

Gastrointestinal Cancers
member photo
Howard S. Hochster, MD

Distinguished Professor of Medicine, Rutgers Robert Woo...

Radiation Oncology
member photo
Howard Sandler, MD, MS, FASTRO

Ronald H. Bloom Chair in Cancer Therapeutics
Pr...

Community Oncology
member photo
Jeff Patton, M.D.

CEO Tennessee Oncology...

Precision Medicine Section Editor
member photo
Jennifer Levin Carter, MD, MPH

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

Financial Sector
member photo
Michael G. King Jr.

Managing Director and Senior Biotechnology Analyst...

Gastrointestinal Cancers
member photo
Richard Goldberg, MD

Director WVU Cancer Institute Director of Cancer Signa...

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

Professor and Director, Division of Hematology Oncology...

Health Policy
member photo
Ted Okon

Executive Director Community Oncology Alliance...

Community Oncology
member photo
Thomas Marsland, MD

Vice President Integrated Community Oncology Network ...

Community Oncology
member photo
William Harwin MD

Florida Cancer Specialists President and Managing Part...

Health Policy
member photo
William McGivney, PhD

National Health Policy Expert...

Payer
member photo
Winston Wong, PharmD

President, W-Squared Group...