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Association Between Reimbursement Incentives and Physician Practice in Oncology

(JAMA Oncology) Jan 3, 2019 - Question: Do the financial incentives within oncology reimbursement affect physicians’ practice patterns?

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Thomas Marsland, MD (Posted: January 22, 2019)

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Financial incentives have and always will drive healthcare. There is no free lunch. This report focuses on treatment practices by physicians depending on the financial incentives. First I strongly believe doctors choose what treatments to recommend depending on what is best for our patients. When efficacy and toxicities are equal then the economics definitely come into play. There are systems where using more expensive therapies are chosen as well as systems where less expensive therapies maybe chosen if there is a financial incentive to do so. Many of the newer models are based on these concepts. Also I would like to point out that that comment about financial incentive clearly applies not just to physicians. Payers also have programs that alter treatment choices due to the economics (prior auths, step therapies, fail first, and more). Gee, bet the PBMs never look at the economics of the treatments they mandate. So let us all agree patients come first and that we need to continue to work to assure that financial incentives work to the benefit of all....

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