Community Oncology Practices

Videos — May 2, 2014


Mark J. Krasna, MD
Corporate Medical Director of Oncology
Jersey Shore University Medical Center
Neptune, NJ

Throughout the United States, community oncology practices still remain the bore of treatment in patients with cancer. In fact, 85% or more of patients receive their cancer care in the community close to home. HCI-designated cancer centers, although they exist throughout the country, do not reach all patients in all communities.

Other referral to HCI-designated centers and other tertiary centers is appropriate and is encouraged for specific subtypes of cancer. Most patient cancer care, especially if it is delivered in the early stages of disease, can be done in the community.

One of the great improvements that was made over the past decade was the initiation of clinical research trials and the use of nurse navigators even in community cancer centers.

The expansion of the navigator role and the use of multidisciplinary cancer care in the community has now made it possible for patients close to home to receive multidisciplinary care with a medical, radiation, and surgical oncologist working collaboratively and having a nurse navigator to help the patients through that process.

One of the main changes in community oncology practices today is the huge realignment of medical, radiation, and especially surgical oncology practices with cancer centers or cancer hospitals.

Due to changes in reimbursement for chemotherapy as well as changes in the high price of technology in radiation oncology as well as some of the challenges of maintaining surgical subspecialty practices, each of these areas has now been incorporated into cancer centers across the country.

A typical community cancer center will now have an employed surgical oncologist or even a subspecialist in breast cancer surgery, lung cancer surgery, and other surgical oncology fields.

Very commonly, radiation oncology practices are now becoming aligned with the hospitals, with the hospitals investing in and building the infrastructure and the capital. They offer the entire team and the physicians providing physician services relationship with their own professional services delivered as part of the private group.

Recently, the greatest change has been documented in the number of medical oncology practices that have now changed their alignment from freestanding private practices either to hospital- employed medical oncology models or models where they are aligned using a PSA, or a Professional Services Agreement.

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