On June 15, the Journal of Oncology Practice published an ASCO article examining the state of oncology practice in the United States as part of its new State of Cancer Care in America™ article series. The State of Oncology Practice in America, 2018 reports on important trends in oncology practice ownership, practice concerns, and the oncology workforce, along with details on the size, geographical distribution, and number of practices currently open in the United States.
Since 2014, ASCO has published an annual State of Cancer Care in America report to examine important trends in the cancer care delivery system. This year, ASCO is broadening to State of Cancer Care in America initiative to include events and a series of timely, in-depth articles that examine practice issues that impact the delivery of efficient, cost-effective, high-quality cancer care.
Key highlights of The State of Oncology Practice in America, 2018 include:
- Practices name payer pressures as number one concern: Fifty-eight percent of surveyed oncology practices now say that their a top concern is payer pressures. A significant increase over concerns reported in 2016, when payer pressures landed in fourth position, practices now report that prior authorizations (78%) and coverage denials and appeals (62%) are the biggest payer pressures they face.
- The oncology practice landscape continues to be in flux: In 2017, one-third (34%) of practices reported some change in organizational structure, including opening a new practice (18%), experience a merger/joint venture (9%), or closing a practice (7%).
- Consolidation continues, but most practices remain small. As of 2017, there are 2,248 total oncology practices in the United States and 12,423 U.S.-based oncologists. From 2016 – 2017, 25% of these practices increased their number of oncologists, while 18% had fewer oncologists. Similarly, while the number of oncologists in the U.S. has grown by 9.5% since 2013, the total number of practices has decreased by a similar margin (9.4%). Despite this consolidation, most practices remain small, with 76% of practices employing 1-5 oncologists, and 72% reporting only one site.
- Most practices are prepared to comply with the Merit-based Incentive Payment System (MIPS). Fifty-eight percent of practices say they are ready to comply with MIPS, but 34% are still unsure if they’re ready.
- Access to cancer care remains a challenge in rural areas. Nearly one-fifth (19%) of the U.S. population resides in rural areas, however only 7% of oncologists practice in rural areas.
The full article is featured as part of a special State of Cancer Care in America article series in the Journal of Oncology Practice. Throughout the year, the special article series will be updated to feature original ASCO research, editorials, and commentaries from ASCO leaders and invited stakeholders that explore the current challenges, opportunities, and trends in the delivery of high-quality cancer care. An introductory editorial about the goals of this new series is also available.