Many cancer patients get their chemotherapy in the offices of oncologists who own their practices, unaffiliated with large hospital systems.
Oncology Specialists of Charlotte is one of those clinics, and earlier this month, it hosted a meeting for patients and health care professionals who want to ensure that cancer specialists who want to remain independent can do so.
“Community clinics just like this one are closing all over the country,” said Rose Gerber, a speaker from the national Community Oncology Alliance.
Gerber and others from the Washington-based alliance encouraged the audience – which included many cancer patients and their spouses – to join the new local chapter of the alliance’s Patient Advocacy Network. Advocates are volunteers who lobby elected officials, raise money, support other cancer patients or share personal stories to effect change and educate the public about cancer.
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One of the issues of concern is reimbursement. Doctors employed by hospitals, even if they work in clinics separate from those hospitals, get paid more for providing chemotherapy than independent doctors. The lower rate is set by Medicare, the government’s health program for seniors, and most private insurance plans follow suit.
Nationally, chemotherapy costs 24 percent more in hospital-based outpatient clinics than in private doctor’s offices, according to a study by Avalere Health. Hospital officials say their charges are justifiably higher because they must cover the cost of non-paying patients and maintain around-the-clock emergency care.
Dr. Justin Favaro, with Oncology Specialists of Charlotte, said the lower reimbursement makes it difficult for community oncologists to run their small businesses. Across the country since 2008, 313 oncology clinics have closed, and 395 are struggling financially, Gerber said. Another 544 practices have been acquired by hospitals.
Following that trend, Charlotte hospital systems are employing more oncologists. When that happens, referrals to independent oncologists decrease because hospital-employed primary care doctors are encouraged to refer patients to oncologists within the hospital system.
Carolinas HealthCare System employs 97 oncologists in Mecklenburg and surrounding counties, including 32 who have been hired since the opening of Levine Cancer Institute in 2011.
Until recently, Novant Health’s Charlotte-area hospitals employed seven oncologists. But the system recently hired six more oncologists, including four from a Matthews group, and plans to hire two more.
At the recent event, Charlotte patients eagerly signed up to support their community oncologists. “I’m one of the lucky ones, but you’ve got to help everybody,” said Alex Sansone, whose multiple myeloma treatment is paid for by insurance and a financial assistance program. “My luck could change next week.”