The Ohio Hematology Oncology Society (OHOS) was formed 2 decades ago to advocate for and provide educational seminars and networking opportunities to hematologists and medical oncologists throughout the states of Ohio and West Virginia. Today, the society is focused on the needs of its nearly 200 members in Ohio (West Virginia formed its own ASCO State Affiliate, the West Virginia Oncology Society, in 2008) in bringing the highest-quality care to patients.
OHOS is very active in the state legislature. In 2011, a bill created by the Society updating Ohio’s regulations on off-label drug indications so it could mirror federal standards was signed into law. The Society has already had two legislative successes this year with the passage of Ohio’s oral chemotherapy parity law, which is awaiting the governor’s signature, and passage of the first state law to prohibit “brown bagging” of chemotherapy drugs—whereby insurers require drug purchase from and/or preparation by designated low-cost pharmacies that ship the drugs directly to patients, disrupting the chain of safe preparation and delivery.
OHOS also helped establish the Ohio Legislative Cancer Caucus, which educates legislators about the myriad issues involved in cancer care, including the need for clinical research and improving patient access to treatment. The Caucus also helps advance state policies in developing strategies for cancer prevention and more effective diagnosis and treatment.
The ASCO Post talked with OHOS President Slobodan M. Stanisic, MD, about the Society’s legislative achievements, its challenges, and its goals for the future.
Similar Local and National Issues
Why was it important for OHOS to become an ASCO State Affiliate and form its own oncology society?
Oncology care nationwide is facing the same business problems and challenges that we are facing on a local level, including declining reimbursement rates, increasing patient workload, and rising administrative burdens from government and private health insurers, so it’s important for all of the State Affiliates to share ideas. A solution to a problem in one state could be an option for a society in another state.
It’s important to share experiences about dealing with issues like getting oncology medications covered and helping patients get financial assistance if necessary. The more ideas that can be generated to solve problems in our practices or for our patients, the stronger all our societies will be.
Also, being affiliated with ASCO gives each state society a certain amount of clout we otherwise wouldn’t have. Instead of having 50 lone voices in the dark, being an ASCO affiliate gives us one larger and stronger voice. Many of our local legislative issues, such as oral chemotherapy parity, are the same issues being confronted on a national level, and being part of ASCO gives us the ability to improve cancer care both locally and nationally.
Practice Setting
Are most of your members in private practice?
Yes. More and more community practices are becoming hospital owned, but most of our members are in private practice.
Legislative Activities
Please talk about your legislative and advocacy efforts.
A major concern of ours has been the practice of brown bagging chemotherapies, in which drugs are shipped directly to the patient rather than to the oncologist’s office, and patients bring their chemotherapies to the oncologist for treatment. The problem is you can’t be sure of what you are getting or whether the drugs were properly prepared, but as physicians, we bear the responsibility if something with the drug preparation goes wrong.
We have worked with other interested parties and insurers for several years to pass legislation to ban the practice of brown bagging in Ohio and were successful this year with the passage of Senate Bill 230. We were also involved in getting an oral chemotherapy parity bill passed after several years of effort.
On a federal level, we are supporting ASCO’s efforts to reduce instability in federal payment systems and eliminate barriers that prevent oncology practices from improving quality oncology care, including reversing sequestration cuts to Medicare payments, removing prompt pay discounts in the average sale price formula, and repealing the sustainable growth rate formula.
We’ve had two other major legislative successes: We worked with the Medicare Carrier Advisory Committee to modify Medicare’s policies on chemotherapy and nonchemotherapy infusion and were able to convince payors to increase reimbursement levels and pay for more than one infusion on a specific date of service. Several years ago, we also got legislation enacted that exempts the purchase of chemotherapy drugs from the state sales tax in Ohio.
Remaining Relevant
What are your greatest challenges?
Our challenges are the same ones other societies are facing, including shrinking reimbursements and the site of care moving away from outpatient centers to academic centers. Recently, we have seen a drop off in membership due in part to the perception of salaried physicians, who don’t have to contend with reimbursement issues, that there is little value in belonging to a state society.
As more oncology physicians leave private practice and become employed in hospital-based and university settings, there is the presumption that they are protected from the issues confronting community oncologists. I don’t know if that is the case, but there is less advocacy of the physician’s individual practice when he or she becomes part of a larger entity.
We have to find solutions to overcome these misperceptions and remain relevant to all oncologists regardless of whether they are in the community, academic, or hospital setting.
Ongoing Objectives
What are your future goals?
We would like to expand our membership and continue to grow as a society. To accomplish this goal, OHOS is fostering cooperation between our members and physicians at the major cancer centers in our state, such as the Cleveland Clinic and The Ohio State University Comprehensive Cancer Center. We continue to upgrade our communication efforts to keep members updated on the rapidly changing world of oncology. In addition, we are reaching out to employers to educate them on the appropriate support for employees diagnosed with cancer.
Closing Thoughts
What else would you like ASCO members to know about OHOS?
As we head into our 21st year as a society, we want oncologists to know that OHOS is here to help them improve their practices so they can offer their patients the best care possible. Our overarching goal is to provide educational programs and networking opportunities members won’t find anywhere else. ■
Disclosure: Dr. Stanisic reported no potential conflicts of interest.
