Community Oncology Conference

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Glossary

1

Community oncology practice

An independent, usually physician-owned oncology practice that delivers chemotherapy, immunotherapy, oral oncolytics and supportive care close to where patients live, rather than inside a hospital outpatient department.

2

Community Oncology Alliance (COA)

US non-profit advocacy and membership organisation for independent community oncology practices. It publishes policy analysis on Medicare payment, 340B and payer conduct, and hosts this annual conference in Orlando.

3

340B Drug Pricing Program

A US federal programme that requires manufacturers to sell outpatient drugs at reduced prices to eligible covered entities. Community practices, contract pharmacy arrangements and proposed eligibility changes are recurring conference topics.

4

340B covered entity and contract pharmacy

The covered entity is the eligible clinic or hospital enrolled in 340B; a contract pharmacy is a third-party pharmacy that dispenses on its behalf. Rules on contract pharmacy registration and audit documentation are a live compliance issue for practices.

5

Buy-and-bill

The payment model in which a practice purchases a drug, administers it in the clinic and then bills the payer, carrying inventory and cash-flow risk until reimbursement lands.

6

White bagging

A payer or PBM requirement that a specialty pharmacy dispense a patient-specific drug and ship it to the practice for administration, bypassing the practice's own buy-and-bill purchase. Practices argue it disrupts inventory control and same-day care.

7

Brown bagging

The patient obtains the drug from an outside pharmacy and brings it to the practice for administration, shifting handling and storage responsibility away from the clinic.

8

Pharmacy benefit manager (PBM)

An intermediary that administers prescription drug benefits for payers, setting formularies, specialty pharmacy networks and reimbursement rates for oral oncolytics.

9

Site-neutral payment

Policies that pay the same rate for the same service whether it is delivered in a hospital outpatient department or an independent practice. It cuts both ways for oncology because hospital outpatient rates and 340B access can be materially higher.

10

Prior authorization

Insurer pre-approval required before a drug, scan or procedure is covered. Delays between diagnosis and first treatment dose are a core operational and advocacy complaint at community practices.

11

Step therapy

A requirement that patients try lower-cost or older therapies before a payer covers the physician's preferred agent, which oncologists argue is poorly suited to time-sensitive cancer care.

12

Average sales price (ASP)

The Medicare benchmark used to pay for Part B drugs, calculated from manufacturer sales data; Medicare pays ASP plus a statutory add-on, so drug margin moves with price changes and sequestration.

13

Medicare Part B versus Part D

Part B covers physician-administered drugs in the clinic; Part D covers oral oncolytics dispensed through a pharmacy. The two channels carry very different dispensing economics for a practice.

14

Oncology Care Model and Enhancing Oncology Model

Centre for Medicare and Medicaid Innovation alternative payment models that pay practices a monthly care-management fee with accountability for spending and quality across a cancer care episode.

15

Alternative payment model (APM)

Any payment arrangement that ties reimbursement to quality, cost or outcomes instead of visit volume alone; practices evaluate APMs against the fixed cost of navigation, data reporting and staff time.

16

MIPS and the Quality Payment Program

Medicare's Merit-based Incentive Payment System scores clinicians on quality, cost, improvement activities and promoting interoperability, producing a payment adjustment two years later.

17

Oncology medical home

A practice operating model built on 24/7 triage, evidence-based pathways, care coordination and patient education to reduce emergency visits and inpatient admissions during treatment.

18

Advanced practice provider (APP)

Nurse practitioners and physician assistants who run treatment visits, manage toxicity, support survivorship and increasingly anchor urgent-care triage lines in community oncology.

19

Biosimilar

A follow-on biologic approved as highly similar to an existing reference product; uptake shifts ASP-based reimbursement and inventory decisions inside the clinic.

20

In-practice dispensing and specialty pharmacy

Dispensing oral oncolytics and supportive drugs directly from the practice, including inventory, prior authorization, refill management and patient copay support.

21

Group purchasing organisation (GPO)

An entity that negotiates drug and supply contracts on behalf of member practices, influencing purchase price and therefore buy-and-bill margin.

22

Revenue cycle management (RCM)

The billing chain from eligibility checks and coding through claim submission, denial management and collections; drug claims and prior authorisations dominate oncology RCM work.