From the Editor

Our inboxes are overflowing with news of the Oncology Care Model (OCM) that was announced by the US Department of Health & Human Services on February 12. Full details are being unveiled regarding this bundled payment model, which was developed by the Centers for Medicare & Medicaid Services (CMS) Innovation Center, and practices are starting to assess the expectations of the program versus the risks and rewards of participation or a decision not to participate.
I was disturbed recently after reading a news report in which the head of a large pharmacy benefit manager (PBM) stated the company’s intentions to eventually start influencing the price of oncology drugs as well as extend its management, oversight, and influence to cancer drugs administered in doctors’ offices and hospitals. Meetings have already begun with top oncologists, according to the company leader who was interviewed, and the company is looking to find ways to eventually guide doctors toward preferred drugs in the PBM’s approved formulary in ways that do not cause patients to be upset.
Those who care for patients with cancer are special. Clinical team and staff members come to work daily not just for a job, but because they care and want to be a part of helping their friends, neighbors, and community battle an insidious disease. Most of us have loved ones who were touched by cancer, and we bring unique, appreciated, and caring attention to those who we serve.
It seems that throughout 2014, those of us in oncology have ­been moving at 100 miles an hour. ­New challenges hit us every day and can involve regulatory or reimbursement issues, patient or personnel concerns, operational setbacks, or any combination of the above. We turn to our colleagues, resources such as Oncology Practice Management, and association conferences and meetings to stay well informed and ready to guide our organizations through the next day, week, month, or year. Despite the speed at which we are moving, though, I am awestruck at how far we still have to go. We are in the midst of a major healthcare transformation, and a window into oncology practices offers a microcosmic view of the entire healthcare system.
Once upon a time, there existed a town–gown divide in healthcare: a large academic center in one part of the state sought referrals from physicians in surrounding communities, but the physicians were reluctant to send too many referrals because often they would not get the patients back.
Xunzi, a Confucian philosopher born in 300 BC, is quoted as saying, “In order to properly understand the big picture, everyone should fear becoming mentally clouded and obsessed with one small section of truth.”
Managing oncology is a challenge from many perspectives. Physicians balance a patient’s medical condition with his or her medical benefit structure as well as physical, mental, social, and financial situation, and strive for the best possible solution.
In just a few short months we will be in Louisville, KY, for our National Organization of Rheumatology Managers (NORM) conference, which is scheduled for September 12-13, 2014. Members of the NORM Board of Directors and various committees have spent innumerable hours throughout the year in planning and organizing the conference so it can meet our members’ expectations.
Managing the compounding and handling of hazardous drugs has always been complicated, but it is the cornerstone of the care we provide. These drugs offer hope to patients battling cancer.
Challenges come from all directions, and good oncology managers have eyes in the backs of their heads. Two significant challenges arose recently, stemming from a common computer operating system platform as well as from the US government.
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