Assessing the Quality of SK&amp;A’s Office-Based Physician Database for Identifying Oncologists

Valdez, Samuel; Jacobson, Mireille

doi:10.1177/10775587211013628

Cited by 3 publications

(4 citation statements)

References 22 publications

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“…Data on oncologists were obtained from the health information company IQVIA. IQVIA’s OneKey (previously SK&A) is an annual compilation of office-based physicians practicing in the US and is estimated to include 74% of oncologists billing Medicare fee-for-service and 90% of physicians across all specialties . As described elsewhere, we linked physician and practice data to annual data on pharmacies using organizational names and locations to identify oncologists and oncology practices that opened and operated on-site pharmacies.…”

Section: Methodsmentioning

confidence: 99%

“…IQVIA's OneKey (previously SK&A) is an annual compilation of office-based physicians practicing in the US and is estimated to include 74% of oncologists billing Medicare fee-for-service and 90% of physicians across all specialties. [10][11][12] As described elsewhere, 1 we linked physician and practice data to annual data on pharmacies using organizational names and locations to identify oncologists and oncology practices that opened and operated on-site pharmacies. Annual data on pharmacies were obtained from the National Council for Prescription Drug Programs, a nonprofit organization that collects registration information on a wide range of pharmacies, including chain and independent retail pharmacies, clinic pharmacies, and nonpharmacy dispensing sites (eg, in-office sites).…”

Section: Datamentioning

confidence: 99%

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Cancer Treatment Before and After Physician-Pharmacy Integration

Kanter,

Ozluk,

Chi

et al. 2024

JAMA Netw Open

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ImportanceIntegration of pharmacies with physician practices, also known as medically integrated dispensing, is increasing in oncology. However, little is known about how this integration affects drug use, expenditures, medication adherence, or time to treatment initiation.ObjectiveTo examine the association of physician-pharmacy integration with oral oncology drug expenditures, use, and patient-centered measures.Design, Setting, and ParticipantsThis cohort study used claims data from a large commercial insurer in the US to analyze changes in outcome measures among patients treated by pharmacy-integrating vs nonintegrating community oncologists in 14 states between January 1, 2011, and December 31, 2019. Commercially insured patients were aged 18 to 64 years with 1 of the following advanced-stage diagnoses: breast cancer, colorectal cancer, kidney cancer, lung cancer, melanoma, or prostate cancer. Data analysis was conducted from May 2023 to March 2024.ExposureTreatment by a pharmacy-integrating oncologist, ascertained by the presence of an on-site pharmacy or nonpharmacy dispensing site.Main Outcomes and MeasuresOral, intravenous (IV), total, and out-of-pocket drug expenditures for a 6-month episode of care; share of patients prescribed oral drugs; days’ supply of oral drugs; medication adherence measured by proportion of days covered; and time to treatment initiation. The association between an oncologist’s pharmacy integration and each outcome of interest was estimated using the difference-in-differences estimator.ResultsBetween 2012 and 2019, 3159 oncologists (745 females [27.1%], 2002 males [72.9%]) treated 23 968 patients (66.4% female; 53.4% aged 55-64 years). Of the 3159 oncologists, 578 (18.3%) worked in practices that integrated with pharmacies (with a low rate in 2011 of 0% and a high rate in 2019 of 31.5%). In the full sample (including all cancer sites), after physician-pharmacy integration, no significant changes were found in oral drug expenditures, IV drug expenditures, or total drug expenditures. There was, however, an increase in days’ supply of oral drugs (5.96 days; 95% CI, 0.64-11.28 days; P = .001). There were no significant changes in out-of-pocket expenditures, medication adherence, or time to treatment initiation of oral drugs. In the breast cancer sample, there was an increase in oral drug expenditures ($244; 95% CI, $41-$446; P = .02) and a decrease in IV drug expenditures (–$4187; 95% CI, –$8293 to –$80; P = .05).Conclusions and RelevanceResults of this cohort study indicated that the integration of oncology practices with pharmacies was not associated with significant changes in expenditures or clear patient-centered benefits.

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Section: Methodsmentioning

confidence: 99%

Section: Datamentioning

confidence: 99%

Cancer Treatment Before and After Physician-Pharmacy Integration

Kanter,

Ozluk,

Chi

et al. 2024

JAMA Netw Open

Self Cite

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“…8 OneKey is an annually compiled file of office-based physicians estimated to cover 74% of oncologists billing Medicare feefor-service and 90% of physicians across all specialties. [8][9][10] OneKey includes physician names, specialties, practice names, practice site addresses, daily patient volume, medical group affiliations, and hospital and health system affiliations. Because OneKey has been reported to understate practices' hospital affiliations, 11 we augmented these data with information from web searches on practices' hospital and health system (ownership) affiliations and, for 2016 and 2018, publicly available vertical integration data from the Agency for Healthcare Research and Quality Comparative Health System Performance Initiative Compendium of US Health Systems.…”

Section: Data and Study Populationmentioning

confidence: 99%

Trends in Medically Integrated Dispensing Among Oncology Practices

Kanter

Parikh

Fisch³

et al. 2022

JCO Oncology Practice

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PURPOSE: The integration of pharmacies with oncology practices—known as medically integrated dispensing or in-office dispensing—could improve care coordination but may incentivize overprescribing or inappropriate prescribing. Because little is known about this emerging phenomenon, we analyzed historical trends in medically integrated dispensing. METHODS: Annual IQVIA data on oncologists were linked to 2010-2019 National Council for Prescription Drug Programs pharmacy data; data on commercially insured patients diagnosed with any of six common cancer types; and summary data on providers' Medicare billing. We calculated the national prevalence of medically integrated dispensing among community and hospital-based oncologists. We also analyzed the characteristics of the oncologists and patients affected by this care model. RESULTS: Between 2010 and 2019, the percentage of oncologists in practices with medically integrated dispensing increased from 12.8% to 32.1%. The share of community oncologists in dispensing practices increased from 7.6% to 28.3%, whereas the share of hospital-based oncologists in dispensing practices increased from 18.3% to 33.4%. Rates of medically integrated dispensing varied considerably across states. Oncologists who dispensed had higher patient volumes ( P < .001) and a smaller share of Medicare beneficiaries ( P < .001) than physicians who did not dispense. Patients treated by dispensing oncologists had higher risk and comorbidity scores ( P < .001) and lived in areas with a higher % Black population ( P < .001) than patients treated by nondispensing oncologists. CONCLUSION: Medically integrated dispensing has increased significantly among oncology practices over the past 10 years. The reach, clinical impact, and economic implications of medically integrated dispensing should be evaluated on an ongoing basis.

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“…Studies of the completeness of the SK&A data set have found it to provide reasonably accurate up-to-date address and ownership information of physicians. [21][22][23] Provider Utilization and Payment…”

Section: Integrated Physiciansmentioning

confidence: 99%

Do Medicare’s Facility Fees Incentivize Hospitals to Vertically Integrate with Oncologists?

Valdez

2021

INQUIRY

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Within the past decade, the U.S. health care market has undergone massive vertical integration, prompting economists to study the underlying causes and consequences of hospital-physician integration. This paper examines whether or not hospitals strategically choose to vertically integrate with clinical oncologists in order to capture facility fees, a commonly cited reason for increased consolidation in the health care market. To address this question, I match data on hospitals’ ownership of clinical oncologists with Medicare payment data disaggregated to the physician and specific service level. I leverage a 2014 policy change that drastically altered the payment structure of Medicare’s facility fees paid to hospitals for evaluation and management services—and yet, it did not alter the direct payments made to physicians. Contrary to popular belief, I find no evidence that the financial incentives of facility fees have an effect on the probability that a hospital and a clinical oncologist vertically integrate.

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Assessing the Quality of SK&A’s Office-Based Physician Database for Identifying Oncologists

Cited by 3 publications

References 22 publications

Cancer Treatment Before and After Physician-Pharmacy Integration

Cancer Treatment Before and After Physician-Pharmacy Integration

Trends in Medically Integrated Dispensing Among Oncology Practices

Do Medicare’s Facility Fees Incentivize Hospitals to Vertically Integrate with Oncologists?

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