MD Anderson's Unusual Partnership Could Cut Care Costs

A unique partnership, the first with a physician-owned group practice promises to change cancer care and reduce its cost.

The University of Texas MD Anderson Cancer Center in Houston has been adding partners to its cancer network for at least six years in a bid to extend its reach nationwide.

A partnership with an independent physician group in New Jersey is the first of its kind and could potentially cut the cost of cancer care while keeping patients close to home, its oncology chief says.

In April 2016, New Jersey's Summit Medical Group announced a partnership with Houston's University of Texas MD Anderson Cancer Center. At first glance, Summit's addition to the MD Anderson Cancer Network seemed identical to four other such partnerships signed since 2011 in Arizona, Florida, California, and at Cooper Health System in southern New Jersey.

But the Summit partnership, which covers the northern portion of the state, is unique in that it's the first with a physician-owned and governed group practice instead of a health system.

The 130,000-square-foot Summit Medical Group MD Anderson Cancer Center is its physical manifestation, and will open in April 2018 next to the medical group's new facility in Florham Park, NJ.

HealthLeaders recently spoke with William DeRosa, DO, its chief of oncology, about the partnership's implications on changing cancer care and reducing its cost. Following is a lightly edited transcript of that conversation.

HealthLeaders: How did the relationship between Summit and MD Anderson come about?

DeRosa: It's unique. Every major cancer center has its own approach. Some want to be regional. Cancer centers like Dana Farber (Boston) and Memorial Sloan Kettering (New York) have a regional presence with a national profile.

Anderson wants to have their intellectual architecture available to one-third of the nation through network and partnership arrangements, and we were their fifth partnership.

The partnership model uses Anderson's expertise to deliver care where the patient lives. We wanted to represent them in the North New Jersey metro marketplace and through Cooper (University Health Care), which had the arrangement with them for Southern New Jersey, we signed an agreement to provide oncologic services for the state's nine northern counties.

HealthLeaders: You say a partnership with a physician group has the potential to reduce the cost of cancer care. How?

DeRosa: We're the largest physician-owned and governed outpatient care delivery system in the country that is agnostic to hospitals. Soon we will have 800 providers with 74 sites, and 1.4 million square feet of clinical space and 10,000 patient visits a day.

We're also the only physician-owned care delivery system partnered with a major cancer center. Every other one is with a hospital or health system. We feel we're able to bring highest level of care in the most value-based way.

As you know, hospital systems bill at the OPPS rate, they get a substantial reimbursement increase because of facility fees and they get 2% more on Medicare (reimbursement). We feel this is the model for the future of cancer care delivery throughout the country.

If we can do this at commercial rates, with none of the rate enhancements of hospitals, and if we can show outcomes that are consistent on a population platform, you then have the power to go into any marketplace and start to go at risk.

That allows you to price the product at a level that will expand care to a greater portion of the population, people who don't have the wherewithal to travel to comprehensive cancer centers. We should have the ability to push out to every patient in the country that level of sophistication.

HealthLeaders: Why do patients often feel the need to travel out of their local area for cancer care and why is this model superior clinically?

DeRosa: Patients go where they feel comfortable and where they perceive they'll get the best care.

Memorial Sloan Kettering is an outstanding facility, but for us, the idea is that not only do you get to stay home, but all the other docs who cared for you here remain involved in your care, as opposed to being disassociated.

With our platform of primary care and other specialties, we take the lead from screening to diagnosis to treatment to curative or palliative care, and everything in that continuum.

Patients don't have to leave the providers who already contribute to their care. By bringing MD Anderson's architecture to an integrated practice, we feel this can be the future of cancer care, from medical to radiation to surgical oncology.

We have subspecialists who concentrate on onco-internal medicine, for example. We have cardiologists, gastroenterologists, endocrinologists, pulmonologists and others who are interested in being able to apply their specialty to the cancer patient.

This is a concept pioneered by MD Anderson, where their specialists are there to take care of cancer patients.

HealthLeaders: Operationally, how does the partnership increase the capabilities of Summit?

DeRosa: If we can do this in conjunction with comparable outcomes, this is the model for the future of cancer care delivery throughout the country.

I just joined a year ago but this comes from the foresight and vision of Dr. (Jeffrey) LeBenger (chairman and CEO, Summit Health Management) and the board. This is a hypercompetitive marketplace and oncology was always the last frontier.

We're at the beginning of precision medicine, the beginning of understanding at molecular level what's really happening in cancer. In medical oncology, our ability to give sophisticated care has continued to evolve and will continue to do so.

In radiation oncology, Anderson feels their treatment plans are unique. Every patient who receives radiation has a treatment plan developed with our chief of radiation oncology who works in conjunction with oncologists at the campus in Houston to make sure it's exactly the same as what they would receive there.

On the medical side, we have the ability to interact with all the major thought leaders in Houston. So any clinic question that requires additional expertise, we can bring a multidisciplinary approach here similar to what's in Houston.