Oncology is a unique and dynamic segment of the US healthcare system. The complexity of the associated diseases, pace of innovation, and myriad treatment options can leave providers struggling to keep up. This clinical and technological innovation comes at a cost, approaching $100 billion annually; as a result, affordability has become a major concern for patients, legislators, and providers alike.
Oncology providers are under pressure to find cost-control measures that ensure patients can afford the care they need while keeping cancer programs financially viable. The recent COVID-19 pandemic has intensified these issues, exposing flaws in the current operating model and accelerating innovation efforts. Oncology providers have significant challenges to overcome as they adapt business and operational practices in search of long-term sustainability.
Congress further delayed the Radiation Oncology (RO) Model, which is now expected to begin January 1, 2022. Participants can use this extra time to their advantage.
The new mandatory payment model is intended to align Medicare’s payments for Part B drugs with prices offered internationally for the same drugs, as well as remove incentives to unnecessarily use higher-cost drugs.
As payers move to restrict hospital-based imaging, here are 6 recommendations to help hospitals mitigate near-term losses and diversify their imaging portfolios.
Explore the anticipated impact of the proposed CMS changes to the MPFS for CY 2021 to avoid possible financial losses for your organization.