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tations to these analyses that attenuatehow these findings should be interpreted.Patients treated in an outpatient hospitalsetting were younger. Therefore, it ispossible more aggressive chemotherapyregimens could have been used, whichmay have resulted in higher costs at thesesites. These studies failed to evaluate differencesin the comorbidities of these patients,which again could have skewed differencesin costs.A recent survey of healthcare plansindicated that the shift of oncology fromthe community setting to the hospital settingwas not a major concern at this time. 11However, if payers are interested in reducingor effectively slowing the increasein oncology-related healthcare costs, thistrend should be more closely evaluated.While this shift in care can substantiallyimpact payers, patients may be impactedthe most. Previous studies indicatethat out-of-pocket costs for Medicarepatients receiving chemotherapy for thetreatment of breast cancer were calculatedat $759 for care in the office-managedsetting versus $814 in the hospitaloutpatient setting. 10 It has been reportedthat private community practices offeredlower out-of-pocket costs for Medicarepatients or patients without supplementalinsurance, and greater accessibility forpatients in varying geographical regionsand rural areas. 10,12,13Given the increased costs and higherinpatient hospitalizations associated withthe delivery of chemotherapy in a hospitaloutpatient environment, and given thedrive in healthcare reform to lower costswhile improving care, it seems the trendof providers, payers and patients shouldbe toward the community oncology centers.It isn’t – and the diminishing numberof community practices reveals this unfortunatereality. To change this reality, itbecomes critical to recognize and communicatethe advantages of community oncologycare to ensure the ongoing sustainabilityof these practices and the benefitsthey deliver.Recently, the Community Countscampaign was launched to help demonstratethis value and communicate thereal, measurable benefits of communityoncology. This physician-led movementgives community practices the tools theyneed to build a unified voice and maketheir value known. A broader knowledgeof this value would provide payers, oncologypractitioners and stakeholders realworldinsight they could use to give physiciansmore choices in where they delivercare and give patients greater options andability to receive that care from a communityprovider.You can download a complimentarycopy of The Value of CommunityOncology: Site of Care Cost Analysis, fromwhich this article was excerpted. Thisstudy fills in the gaps in current cost-analysisof community and hospital oncologyutilization and cost benefits. To downloadthe study now and learn more about theCommunity Count campaigns, visit www.OurCommunityCounts.org and see the adon page 2.Top 10 Payer Priorities in Oncology1. High-priced new products2. Cost of hospitalizations3. Ability to compare and analyzepharmacy and medical benefit4. Need to increase use of generics5. Appropriate use of biomarkers6. Pathway implementation7. Appropriate use of hospice8. Compliance and persistency withoncology drugs9. Cost of emergency room visits10. Movement of community-basedcare to hospital-affiliated practicesReferences:1. Association of Community Cancer Centers. The changing face of oncology. 2012. http://www.accc-cancer.org/association/History.asp. Accessed September 1, 2012.2. Dollinger, M. Guidelines for hospitalization for chemotherapy. Oncologist. 1996;1(1,2):107-111.3. American Society of Clinical Oncologists. ASCO Statement on Medicare Drug Reimbursement. June 2, 2000. http://www.asco.org/ASCOv2/Press+Center/ Latest+News+Releases/ASCO+Statement+on+Medicare+Drug+Reimbursement. Accessed September 20, 2012.4. Goldstein, M. Systems perspective: the community-based oncology practice. Ensuring quality cancer care through the oncology workforce: sustaining research and care in the 21st century. Presentation at: ASCO NationalCare Policy Forum Workshop. October 20-21, 2008.5. Kuznar, W. Community oncology clinics under increasing financial pressure. Association for Value-Based Cancer. http://www.valuebasedcancer.com/article/community-oncolo-gy-clinics-under-increasing-financial-pressure.Accessed September 18, 2012.6. Guy, GP Jr, Richardson, LC. Visit duration for outpatient physician office visits among patients with cancer. Am J Manag Care. 2012 May;18(5 Spec No. 2):SP49-56.7. Community Oncology Alliance. Practice Impact Report. April 4, 2012. http://www.communityoncology.org/pdfs/community-oncology-practice-impact-report.pdf Accessed August 23, 2012.8. Goins, R. The Oncology Landscape: Complexity, Cost, Care, and Coordination. Pharmacy Times. May 18, 2011. http://www.pharmacytimes.com/publications/specialty- pt/2011/May2011/The-Oncology-Landscape-Complexity-Cost-Care-and-Coordination. Accessed September 18, 2012.9. Avalere Health, LLC. Avalere Health Analysis Report of National Association of Managed Care Physicians member data. Total cost of cancer care by site of service: physician office vs outpatient hospital. March 2012.http://www.avalerehealth.net/news/2012-04-03_COA/Cost_of_Care.pdf. Accessed August 20, 2012.10. Fitch K, Pyenson B. Milliman Client Report: Site of service cost differences for Medicare patients receiving chemotherapy. October 19, 2011. http://publications.milliman.com/publications/health-published/pdfs/site-of-service-cost-differences.pdf. Accessed August 20, 2012.11. Xcenda. Managed Care Network. PayerPulse June 2012.12. Shea AM, Curtis LH, Hammill BG, et al. Association between the Medicare Modernization Act of 2003 and patient wait times and travel distance for chemotherapy. JAMA.2008;300(2):189-196.13. Neuss MN, Guidi T. Commentary: when it comes to chemotherapy, location matters. J Oncol Pract. 2010 Sep;6(5):235-237.ASD Healthcare 39