Challenges Facing Clinicians and Community Oncology Practices
Community oncology practices across the country are grappling with a growing financial burden that threatens their ability to deliver consistent, high-quality care. As the landscape of cancer treatment evolves—with advanced medications, new technologies, and rising operational costs—smaller, independent practices are feeling the squeeze more than ever.
Nini Wu, MD, MBA, chief medical and development officer of Navista, a Cardinal Health company, addresses the escalating financial pressures in oncology care.
“When we think about the practices, community practices have to shoulder a significant amount of financial burden with purchasing the equipment, purchasing medications upfront because of reimbursement through buy and bill. And with that, they're often waiting for the investment—that impacts the cash flow and impacts the financial stability of the practices,” Wu explains.
With cancer projected to be among the most expensive medical conditions, Wu outlines the significant hurdles facing community oncology practices as they strive to manage these rising costs while upholding high-quality patient care. Her insights delve into the multifaceted challenges impacting clinicians, practices, and, critically, the patients and their care partners navigating this complex landscape.
She explains the financial model of "buy and bill," where practices must purchase medications upfront and wait for reimbursement, the uncertainty around healthcare policy, particularly regarding Medicare reimbursement, and inflation that has steadily eroded the value of reimbursement over the past decade.
“Analyses have shown that overall payment cuts may hit as high as 3 to 4 percent. And that is significant because, in the community, the practices are not always large, and they do not have the support that you may find in the academic side or in larger groups. So they are challenged having to deal with this,” says Wu.
“In addition, you know, inflation materially impacts that. When we look back over the past, one study showed that over the past 12 years or so, there has really been no fundamental change in the level of reimbursement from a community practice viewpoint,” she adds.
