ASCO Practice Census Survey Identifies Challenges Facing U.S. Oncology Practices

As reported in the Journal of Oncology Practice by Kirkwood et al, the recent ASCO Oncology Practice Census survey has identified a number of factors considered to be challenging by oncology practices in the United States.

Study Details

ASCO used Medicare Physician Compare data to characterize U.S. hematology/oncology practices. A total of 2,248 practices provided care to adult patients in 2017. Of these, 394 (18%) completed the survey; the respondents accounted for 58% of the U.S. hematologist/oncologist workforce (n = 7,203). Respondents tended to be larger practices and to encompass more sites than nonrespondents.

Key findings of the survey included the following:

  • Between 2013 and 2017, there were annual decreases in number of practices (range = 0.3%–5.1%)
  • Between 2013 and 2017, there were annual increases in number of hematologists/oncologists (range = 0.1%–3.5%)
  • Practices cited payers (58%), competition (38%), and staffing (37%) as primary sources of strain in day-to-day operations.
  • Prior authorization was dominant among payer pressures (78%), followed by coverage denials and appeals (62%).
  • Electronic health records (EHRs) constituted a burden on practices, with only 15% reporting full interoperability.
  • Hospital/health system–owned practices were more likely than other practices to report EHR use (45% vs 31%) as a pressure, whereas physician-owned practices were more likely than other practices to report practice expenses (49% vs 26%) and drug pricing (43% vs 21%) as a top pressure.

The investigators concluded, “The results of ASCO’s…survey indicate that oncology practices are challenged by day-to-day operations, often related to payment, reimbursement, and competition. Our findings likely represent conservative estimates of such burdens because they are driven by responses from midsized to large-sized organizations, which have lower relative administrative burden, greater market influence, and potentially better ability to adapt in a changing health-care environment.”

M. Kelsey Kirkwood, MPH, of ASCO, is the corresponding author for the Journal of Oncology Practice article. 

The content in this post has not been reviewed by the American Society of Clinical Oncology, Inc. (ASCO®) and does not necessarily reflect the ideas and opinions of ASCO®.


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