Practice Consolidation Among US Medical Oncologists, 2015-2022.

Area of Science:

• Health Services Research
• Oncology Practice Management
• Healthcare Economics

Background:

• Healthcare consolidation impacts cancer care delivery.
• Oncology practices have undergone significant consolidation over the past two decades.
• Understanding these trends is crucial for maintaining quality cancer care.

Purpose of the Study:

• To investigate practice consolidation trends among medical oncologists (MOs).
• To identify factors associated with MO practice consolidation.
• To analyze changes in the geographic distribution of MOs.

Main Methods:

• Utilized Medicare data from 2015-2022.
• Assessed MO practice consolidation using the Herfindahl-Hirschman Index (HHI) in hospital referral regions (HRRs).
• Examined MO distribution across counties using the Gini coefficient and employed multivariable linear regression to identify associated factors.

Main Results:

• The number of MOs increased 14.5%, while practices decreased 18.0%, leading to larger average practice sizes (4.26 to 5.95 MOs/practice).
• Median HHI increased by 9%, indicating greater MO practice consolidation.
• Higher baseline hospital consolidation and more hospital beds per capita correlated with MO practice consolidation; county-level MO distribution remained stable.

Conclusions:

• Medical oncology practices were highly concentrated in 2015 and further consolidated by 2022.
• While MOs' geographic distribution at the county level was stable, the effects of consolidation on cancer care cost, quality, and access require further investigation.
• Findings have significant implications for policymakers and payers in designing programs for high-quality, affordable cancer care.