Kurt Ullman

Operating margins for community oncology practices are decreasing, although the trend seems to be slowing, buying some time for practices to adjust their business models and perhaps survive.

The new "in" term among those looking to lower the cost of health care is "bundled payment." However, it's harder to establish set payment schedules for some specialties that won't financially harm practices.

The high cost of cancer treatments means that commercial payers will be increasing their management in the category and oncology practices may find it harder to stay viable.

Many practices are viewing CMS's Recovery Audit Contractors as bounty hunters. These auditors are reviewing claims on a post-payment basis and having a good rationale for a treatment or intervention may not always be enough.

Affordable Care Organizations have been gaining ground among private payers, but the practices in these ACOs need to be aware of potential legal issues of referring patients to other members in the organization.

When trying to decide which practice model is best for you, business, personal and community variables all enter in. And yet, for some physicians the decision sometimes boils down to one important criterion.

Driven by reimbursement and changes in standards of care, independent community oncology practices continue to dwindle as smaller practices struggle to provide all the needed resources.