Creating an Oncology Practice Plan That Can Change with the Times

In Brief

Medical oncologist workflows have changed dramatically in view of precision medicine, new therapeutic agents, and sub-specialization in oncology. Relative value unit (RVU)-based practice plans lack financial incentive for cooperation and sharing of knowledge and patients, which is required for current best practices in cancer care. To improve cooperation and sharing, Aurora Health Care formed a Practice Plan Development Committee of medical oncologists, service line leadership, finance leadership, and a practice plan consultant. The committee established goals that would enhance collaboration, modify physician behavior to meet the needs of the group, allow payment for non-RVU-generating activities, create a more equitable distribution of expertise, facilitate intra-group consultation, and create more evenly developed compensation. A plan was developed to reward non-RVU-generating activities that benefited the cancer program and medical group. This plan included the creation of a pool where a percentage of compensation, above a threshold, was established and equally divided at the end of the calendar year. Citizenship criteria were established to benefit the health system, medical group, and individuals and demonstrably modified behavior. All members of the medical group (physician practice) agreed to move to the new model. It has resulted in continuous improvement of defined goals with reduced variation in income, increased clinical trial volume by 400 percent, and increased sub-specialization within the medical oncology group.

Acknowledgment

We acknowledge Lorene Schweig, MS, RN, medical writer and editor, Advocate Aurora Health Research Institute, and Cordell Mack, Partner, Health Care Futures, L.P., Edina, Minn., as our consultant for practice plan development.

Additional information

Notes on contributors

James L. Weese

James L. Weese, MD, FACS, is vice president for the cancer program for Aurora Health Care in Milwaukee, Wisc., overseeing the care of nearly 9,000 new patients with cancer yearly. Amy Bock, RN, MBA, BSN, OCN, is the senior director of Clinical Program Strategy for the Cancer Service Line; Jacob C. Frick, MD, (retired) was physician director of Medical Oncology; Federico A. Sanchez, MD, is medical director for Oncology; and Marija Bjegovich-Weidman, RN, MSN, BSN, CCAP, (semi-retired) was senior director for the Cancer Service Line when the practice plan was developed at Aurora Cancer Care, Advocate Aurora Health, Milwaukee, Wisc. E. Stuart Arnett, MBA, (retired) was chief financial officer of the Aurora Health Care Medical Group in Milwaukee, Wisc., and led the development of revised physician compensation plans for all major Aurora Health Care Medical Group clinical service lines and departments. Corey J. Shamah, MD, is director of Physician Informatics for Aurora Cancer Care, Advocate Aurora Health in Milwaukee, Wisc.

Jacob C. Frick

James L. Weese, MD, FACS, is vice president for the cancer program for Aurora Health Care in Milwaukee, Wisc., overseeing the care of nearly 9,000 new patients with cancer yearly. Amy Bock, RN, MBA, BSN, OCN, is the senior director of Clinical Program Strategy for the Cancer Service Line; Jacob C. Frick, MD, (retired) was physician director of Medical Oncology; Federico A. Sanchez, MD, is medical director for Oncology; and Marija Bjegovich-Weidman, RN, MSN, BSN, CCAP, (semi-retired) was senior director for the Cancer Service Line when the practice plan was developed at Aurora Cancer Care, Advocate Aurora Health, Milwaukee, Wisc. E. Stuart Arnett, MBA, (retired) was chief financial officer of the Aurora Health Care Medical Group in Milwaukee, Wisc., and led the development of revised physician compensation plans for all major Aurora Health Care Medical Group clinical service lines and departments. Corey J. Shamah, MD, is director of Physician Informatics for Aurora Cancer Care, Advocate Aurora Health in Milwaukee, Wisc.

Federico A. Sanchez

James L. Weese, MD, FACS, is vice president for the cancer program for Aurora Health Care in Milwaukee, Wisc., overseeing the care of nearly 9,000 new patients with cancer yearly. Amy Bock, RN, MBA, BSN, OCN, is the senior director of Clinical Program Strategy for the Cancer Service Line; Jacob C. Frick, MD, (retired) was physician director of Medical Oncology; Federico A. Sanchez, MD, is medical director for Oncology; and Marija Bjegovich-Weidman, RN, MSN, BSN, CCAP, (semi-retired) was senior director for the Cancer Service Line when the practice plan was developed at Aurora Cancer Care, Advocate Aurora Health, Milwaukee, Wisc. E. Stuart Arnett, MBA, (retired) was chief financial officer of the Aurora Health Care Medical Group in Milwaukee, Wisc., and led the development of revised physician compensation plans for all major Aurora Health Care Medical Group clinical service lines and departments. Corey J. Shamah, MD, is director of Physician Informatics for Aurora Cancer Care, Advocate Aurora Health in Milwaukee, Wisc.

Marija Bjegovich-Weidman

James L. Weese, MD, FACS, is vice president for the cancer program for Aurora Health Care in Milwaukee, Wisc., overseeing the care of nearly 9,000 new patients with cancer yearly. Amy Bock, RN, MBA, BSN, OCN, is the senior director of Clinical Program Strategy for the Cancer Service Line; Jacob C. Frick, MD, (retired) was physician director of Medical Oncology; Federico A. Sanchez, MD, is medical director for Oncology; and Marija Bjegovich-Weidman, RN, MSN, BSN, CCAP, (semi-retired) was senior director for the Cancer Service Line when the practice plan was developed at Aurora Cancer Care, Advocate Aurora Health, Milwaukee, Wisc. E. Stuart Arnett, MBA, (retired) was chief financial officer of the Aurora Health Care Medical Group in Milwaukee, Wisc., and led the development of revised physician compensation plans for all major Aurora Health Care Medical Group clinical service lines and departments. Corey J. Shamah, MD, is director of Physician Informatics for Aurora Cancer Care, Advocate Aurora Health in Milwaukee, Wisc.

E. Stuart Arnett

James L. Weese, MD, FACS, is vice president for the cancer program for Aurora Health Care in Milwaukee, Wisc., overseeing the care of nearly 9,000 new patients with cancer yearly. Amy Bock, RN, MBA, BSN, OCN, is the senior director of Clinical Program Strategy for the Cancer Service Line; Jacob C. Frick, MD, (retired) was physician director of Medical Oncology; Federico A. Sanchez, MD, is medical director for Oncology; and Marija Bjegovich-Weidman, RN, MSN, BSN, CCAP, (semi-retired) was senior director for the Cancer Service Line when the practice plan was developed at Aurora Cancer Care, Advocate Aurora Health, Milwaukee, Wisc. E. Stuart Arnett, MBA, (retired) was chief financial officer of the Aurora Health Care Medical Group in Milwaukee, Wisc., and led the development of revised physician compensation plans for all major Aurora Health Care Medical Group clinical service lines and departments. Corey J. Shamah, MD, is director of Physician Informatics for Aurora Cancer Care, Advocate Aurora Health in Milwaukee, Wisc.

Corey J. Shamah

James L. Weese, MD, FACS, is vice president for the cancer program for Aurora Health Care in Milwaukee, Wisc., overseeing the care of nearly 9,000 new patients with cancer yearly. Amy Bock, RN, MBA, BSN, OCN, is the senior director of Clinical Program Strategy for the Cancer Service Line; Jacob C. Frick, MD, (retired) was physician director of Medical Oncology; Federico A. Sanchez, MD, is medical director for Oncology; and Marija Bjegovich-Weidman, RN, MSN, BSN, CCAP, (semi-retired) was senior director for the Cancer Service Line when the practice plan was developed at Aurora Cancer Care, Advocate Aurora Health, Milwaukee, Wisc. E. Stuart Arnett, MBA, (retired) was chief financial officer of the Aurora Health Care Medical Group in Milwaukee, Wisc., and led the development of revised physician compensation plans for all major Aurora Health Care Medical Group clinical service lines and departments. Corey J. Shamah, MD, is director of Physician Informatics for Aurora Cancer Care, Advocate Aurora Health in Milwaukee, Wisc.