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Scaling Cancer Care

Cindy Sanders, Nashville Medical News

Nashville Oncology Programs Expand, Spread

Metastatic cancer … not the best news a patient can receive, but ‘metastatic’ cancer care … that just might be a different story.

Recently, Nashville oncology programs have initiated partnerships, purchased practices, and entered into collaborative agreements to enhance and improve cancer care in a rapidly changing landscape. Although the reasons vary, the bottom line for patients seems to be better care delivered closer to home.

Driving the Research Forward
Almost from inception, what is today known as Sarah Cannon Research Institute (SCRI) was committed to partnering with community providers as a means of expanding clinical trials to drive research efforts. “From the very beginning, one of the premises was to take the research to the patient … not making the patient come to the cancer center,” said Howard A. Burris, MD, chief medical officer and executive director of drug development for SCRI.
Founded in its present format in 2004 in partnership with HCA, the roots of SCRI go back a decade before that to Tennessee Oncology. At the end of 2012, the practice stepped out of the ownership piece of SCRI, but the institute remains home base for all of Tennessee Oncology’s research endeavors. Additionally, noted Burris, six other of the largest oncology practices in the nation — located in Florida, Ohio, South Carolina, Texas and Virginia — also conduct their research through SCRI.

Today, noted Burris, “There are probably 60-80 unique sites where we’re doing trials with some (locations) just having one trial and others doing dozens. We’ve got trials on the West Coast and East Coast and in the middle part of the country. We also now have trials in the United Kingdom.” More than 700 physicians on two continents participate in clinical trials through the affiliated network.

“We know you’ll get better care all around if you can get it closer to home,” said Burris. He added that while oncologists provide one part of a patient’s care, family members and friends provide the emotional support that is a critical component of the overall care plan. “We’re coming to appreciate that more and more.”

When cutting-edge care and clinical trials can be delivered within the community, then patients and physicians both benefit. In fact, Burris noted, the science has greatly expanded treatment options. “We’ve had dozens of new cancer therapies approved in the last seven to eight years,” he pointed out. “There are three new melanoma therapies in the last year, six new therapies for kidney cancer in the last five years,” he continued. “We’ve personally been involved in more than 50 drugs that have been FDA-approved.”
Yet, Burris said, that success could have an unintended consequence. With more options for treatment comes the threat of complacency, but the newer therapies only go so far. “Part of our growth in infrastructure is we’ve got to empower, support, educate … do everything we can … to make sure the (community) doctors have everything they need to be able to participate in clinical trials,” he said. “You have to keep the enthusiasm high to keep pushing the science forward.”
Tennessee Oncology
Economies of Scale

When Tennessee Oncology’s CEO Jeff Patton, MD, joined the practice in 1996, three years after it was founded, he was the 15th physician. “In the last 12 months, we’ve added 15 physicians,” he said.
Today, the large practice is home to nearly 80 physicians, 24 physician extenders and 700 employees spread over more than three-dozen locations in Middle and East Tennessee. The practice actually expanded across the border into Georgia when Tennessee Oncology acquired Chattanooga Oncology & Hematology Associates … including its Ringgold, Ga. site … at the beginning of 2013.

“We want to be the oncology solution,” said Patton. “And to be the oncology solution, you have to provide the best outcomes at the lowest price.”
Throughout healthcare, he continued, we are seeing partnerships, collaborations and consolidation. “We’re quickly evolving away from fee-for-service to value-based payments, and you really need scale to do that.”
He added Tennessee Oncology is investing in infrastructure and processes to make the practice more nimble in light of the changing reimbursement world. While market share matters from a financial standpoint, he was quick to add it also makes a difference to patients. “Medical oncology is a very portable specialty,” he noted. “To deliver care closer to home is a great value to patients.”

Although the practice doesn’t have any imminent expansion announcements, Patton certainly didn’t rule out additional acquisitions in the future if it makes sense for the practice and for patients.