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Oncologists Must Learn to Manage Clinical, Financial, & Operational Costs

Oncologists Must Learn to Manage Clinical, Financial, & Operational Costs

ATLANTA—"Declining reimbursement rates are forcing oncologists to manage their practices more efficiently," Thomas R. Barr, MBA, executive director of Oncology Metrics, said at the oncology business management session of the American Society of Clinical Oncology 42nd Annual Meeting.

In today's fiscally challenged environment, he said, there are meaningful cost and care improvement opportunities available within three domains in the typical medical oncology practice: clinical, financial, and operational.

"The clinical domain is the area that physicians are trained to manage. Historically, if oncologists were able to manage the clinical aspects of their practice well, the rest took care of itself," he said.

Mr. Barr noted that in today's environment the financial domain has become increasingly important; however, few clinicians have proper training in areas such as purchasing, capital accumulation and management, accounting, billing and collection, and return on equity investment. "Consequently, this domain is where a good practice business manager comes into play," he said.

The operational domain deals with "how processes within the practice work, or don't work, to support each other," he said. The operational domain is where the interactions between the clinical chart and billing process are made; drug inventory is managed; and scheduling, patient processing, new patient intake, patient collections, infusion chair management, and all of the other interactions where information or materials are recorded, purchased or used, he said.

Operational Efficiency

Elaine L. Towle, CMPE, program director, Oncology Metrics, explained that private oncology practices are faced with numerous issues such as new billing codes, another demonstration project, pay-for-performance initiatives, reimbursement threats, and cost containment pressures. "Accordingly, we are forced to make tough 'operational efficiency' decisions about how to treat and support our patients," Ms. Towle said.

She defined operational efficiency as the ability to produce the desired effect with a minimum of effort, expense, or waste. It's important to focus on the largest expenses first, she said. The largest area of expense is drug expenditure, (62%), followed by physician expense (26%). The focus of her presentation was physician efficiency and expense.

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