heme/onc insight please

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Compensation will likely take a big hit in the 5 yrs with healthcare reform, because it is probably the most suspectable field to Medicare legislation that would change physician billing. Currently compensation is significantly determined by the cost of drugs administered; that method is sure to be impacted either by mandating reduced physician fees for service or cost of drugs themselves.
Moreover, there may be more office headaches / hurdles with extensive preapproval processes for oral chemotherapies, preauths for PET/MRIs, molecular testing, etc. A lot of this is going on already, but I expect it may get much worse within 5 yrs as Medicare reform get underway. Also the rise of oral meds in lieu of intravenous agents is benefiting drug companies but not really oncologists.
There are some pluses though - for example, I predict maintenance regimens (like currently in NSCLC) for stable disease will become more commonplace and that may boost physician compensation.
 
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