WASHINGTON--Managed care holds tremendous opportunities for oncologists who are able to restructure their practices to meet the challenge, Merrick Reese, MD, said at the Association of Community Cancer Centers (ACCC) meeting.
Dr. Reese, of Physician Reliance Network, a Texas-based oncology practice management company, believes that the aim of oncology practices should be cancer management, in which care is provided from the time of diagnosis, through active treatment and follow-up, and ending with the patient's re-entry into primary care.
In such a system, the oncologist becomes the gatekeeper, in effect, the primary care physician, for the cancer patient, which eliminates barriers to referral and avoids fragmentation of care, he said.
Such a strategy means forming multispecialty physician networks and bundling all the services the cancer patient requires into one entity for purposes of contracting with plans seeking to "carve out" their oncology services.
Such contracts could include all the medical oncology inpatient and outpatient services, pharmacy and diagnostic services, radiation therapy and professional technical services, and all hospital days not related to surgery, although he expects oncologists eventually to be able to include the cost of surgery in their capitation rates.
He also warned that if oncologists don't take the lead in forming cancer management groups, they may be left behind, as psychiatrists were when investors and psychologists joined together to provide substance abuse management and mental health services to managed care plans.
Dr. Reese believes that such integrated physician networks will also play a major role in clinical trial management. For example, the Physician Reliance Network was asked by a major pharmaceutical company to provide 25 patients for a trial within 6 months, and was able to provide 50 patients in 4 weeks. "I think that really got their attention," he said.