Health Reform Projected to Boost Demand for Oncology Services

Demand for oncologists and radiation oncologists will continue to outpace supply over the next decade.

Demand for oncologists and radiation oncologists will continue to outpace supply over the next decade as more patients become insured under the Affordable Care Act (ACA), researchers reported in the January issue of Journal of Oncology Practice.

By 2025, overall demand for oncologists and radiation oncologists is expected to grow by 40% while the supply will increase by just 25%, resulting in a market shortfall of 2,393 full-time equivalent physicians when the ACA is fully implemented, according to the study. As more people become insured under the ACA, demand for oncologists’ services will rise by an estimated 500,000 visits in 2025 alone, researchers said.

The bulk of the increase will come from 11 million patients expected to enroll in Medicare over the next decade, boosting demand from 39 million to 69 million oncology visits by 2025, according to the study. At the same time, newly insured patients under age 65 will increase overall demand by 2 million to a total of 22 million visits in 2025.

On the supply side, researchers estimated that 1,000 more clinical full-time equivalent oncologists will be needed by 2020 to compensate for the number of physicians in academia who spend only part of their time on clinical care. A 2007 study by the American Society of Clinical Oncology found that 32% of oncologists and radiation oncologists worked in academic medical centers and that they provided 48% fewer clinical services than their counterparts in private practice.

The best strategy for dealing with the looming shortage may be increasing productivity through more collaborative, coordinated care within affordable care organizations (ACOs), researchers said.

“Through health reform, hundreds of ACOs have been formed, some implementing clinical pathways to standardize oncology treatment, which are expected to standardize care and may enhance physician productivity and reduce costs,” the authors wrote. “Disease-specific ACOs for oncology care would particularly focus on standardizing care pathways, using an integrated care approach, and improving counseling of patients on how to manage the course of disease.”

Research has shown that practices that incorporate advanced-practice providers see significantly more new patients per full-time equivalent physician than other practices, according to the study. The authors advised providing oncology-specific training for advanced practice providers and training oncologists in team-based care.

“We estimate that a significant shortage may still occur unless productivity and supportive clinical staff increase,” the authors wrote. “Although more administrative duties may come with ACOs, oncologists and radiation oncologists should prioritize cancer-specific standardized care pathways to make care coordination more fruitful.”