Jordan Johnson, Founder and Principal at Bridge Oncology and Legal Data Expert, shared on LinkedIn:
“For more than a decade, hospital-based conversion was viewed as the financial answer for struggling oncology programs. Higher Medicare reimbursement under the Hospital Outpatient Prospective Payment System (OPPS), facility fees, and provider-based billing drove hospitals to acquire physician practices across the country.
The proposed CY 2027 CMS OPPS Rule signals that the strategy is changing. CMS continues its march toward site-neutral reimbursement, while introducing new compliance requirements for off-campus provider-based departments, including location-specific NPIs, mandatory attestations, and increased audit oversight.
For radiation oncology, this creates a critical strategic question. The issue is no longer, ‘Can we become hospital-based?‘ It’s ‘Will provider-based status continue to create enough value to offset the additional regulatory burden, operational complexity, and long-term reimbursement pressure?‘
The organizations that will thrive won’t simply have the highest reimbursement. They’ll have the strongest operations, disciplined capital planning, efficient revenue cycle management, and sustainable clinical models.
Provider-based status is no longer just a billing strategy. It’s an enterprise strategy – and every oncology leader should be evaluating what the next five to ten years will look like before making that decision.
This is what further differentiates Bridge Oncology with over 20 years of legal and health policy experience. As you can see it matters more than you realize.”
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