After completing residency, I entered private practice in 2000 and joined a large single-specialty practice in Florida. Since then, my physician practice has grown into a very large multi-specialty oncology services company. During this period of growth, I was fortunate to become involved in various key administrative projects related to payer contracting, revenue cycle management, business intelligence and compliance and to have been mentored by smart people in each of these functions that are critical to the business of medicine. One specific project worth mentioning is my company’s design and execution of an alternative payment model for radiation oncology in 2012, which was a first between a practice and a commercial insurer. That agreement remains active today, and our company has executed similar agreements since then with other private payers.
Over time, it became clear to me that ASTRO’s Health Policy committees were addressing many of the same problems – improper claims denials, incorrect coding, out-of-date coverage policies, and others – that I needed to solve within my administrative capacity for my company. I first joined the Payer Relation Committee and was impressed with the seriousness and efficiency with which the group worked in effectively managing coverage problems related to Medicare and private insurance policies. I have since worked on all other Health Policy committees and currently serve as Health Policy Co-chair. Looking ahead, I believe that Health Policy staff and members have accrued valuable knowledge that will be brought to bear on the upcoming challenges of payment reform in our specialty.