Oncologist Alignment

Hospital and Physician Alignment

Are All of Your RVUs Captured?

OCI and its partners have the expertise and capabilities to assist both hospitals and practices with their transition or provide clarity to their existing relationship. Our services can range from assisting in negotiating the optimal business relationship on behalf of either party, all the way to managing the agreed upon employment or Professional Service Agreement on behalf of the practice and hospital. The value we provide to both the hospital and practice is multifaceted and stems from the fact that we understand the uniqueness of oncology in both the hospital and practice site of service. Our understanding encompasses the differences in billing under the Hospital Outpatient Prospective Payment System (HOPPS) versus freestanding billing on a HCFA 1500, which can reflect the differences in the mindset of each organization.

Our knowledge, experience, and complete understanding gives us the ability to effectively and efficiently manage the hospital oncology service line, the physician practice, the data infrastructure, and the EMR/EHR environment. This “total solution” approach allows us to properly account for ALL services rendered. This ensures that the physicians are receiving the full credit for all of the work they are performing and the hospital is getting paid for those services. Our past experience shows that hospital – physician relationships can deteriorate due to something as simple as differences in data. Therefore, managing and interpreting the data to maintain the reporting capability that the “freestanding” practice is accustomed to seeing is important. The hospital and physicians should understand and agree on the metrics that determine success in the relationship. By clearly defining, measuring, and reporting the metrics for success, the probability for long-term viability is maximized.

Why should you engage OCI to manage your Oncology Service Line Relationship?

  • We have a team of proven oncology executives with skill sets that include: transactions, mergers, acquisitions, managed care contracting, hospital service line management, physician practice management, hospital oncology revenue cycle management, and physician revenue management
  • Clinical pathway collaboration and deployment
  • Revenue Cycle Management
    • We provide oncology specific billing expertise and services to hospitals and practices
    • We completely understand the similarities and differences of each site of service and have the knowledge and expertise to ensure that all parties understand the impact of those differences
    • This experience ensures that all services are billed compliantly and that all associated RVUs are captured and accounted for properly
  • Hospital engagement strategies
    • We help ensure that valuable and sustainable relationships are structured between both parties
    • All healthcare is local and oncology is no exception, therefore one employment model does not fit all markets. Ensuring that the hospital – physician structure matches the market is essential for long-term success
  • Oncology inventory management expertise ensures that the projected financials meet expectations
    • Revenue maximization pharmacy practices are developed and deployed
    • Oncology specific utilization management is typically required
    • Waste policies and drug replacement strategies are tailored for each institution
  • Managed Care contracting
    • Oncology specific knowledge is dependent upon a successful payer strategy
    • The drive for healthy outcomes requires competitive pricing be dependent upon local market competition for ambulatory services
    • Competitive pricing ensures that patient volumes and payer mix are maintained for clinical staffing post transition
  • EMR Enhancement and System Management
    • Maintain and manage the Oncology specific EMR for both Radiation and Medical Oncology
      • Creates the comprehensive cancer center experience for the patient
      • Assists with meeting meaningful use and improve quality
      • Maximizes charge capture
  • Why Medical Oncology Total Solutions Management?
    • Independent oncology experienced entity that:
      • Ensures the proper capture and coding of all RVUs and ensures compliance
      • Has the knowledge and expertise to support all parties through every phase of the service line agreement’s lifecycle
      • We currently work with all sizes of hospital systems including large and small publicly traded health systems, not for profit systems, academic medical centers,  and National Cancer Institute (NCI) designated cancer centers.