The Evolution of Buy-and-Bill

Following a brief discussion of the shortcomings of the buy-and-bill model in oncology, Michael Kolodziej, MD, and Brian Kiss, MD, describe the origins of the model and suggest changes needed based on the evolution of healthcare reimbursement strategies in the United States.

Dr Kolodziej defends the buy-and-bill model, explaining that it originated in the 1980s as a way for practices to help pay for the infrastructure needed for cancer care to be delivered in the community setting rather than in the hospital setting.

Because treatment options in oncology have evolved and oral oncolytics that can be dispensed via practice-based pharmacies are now available, adds Dr Kiss, the latest challenge is determining how to compensate oncologists fairly given the introduction of oral drugs.

Resolving these issues will require agreement and collaboration among multiple stakeholders in healthcare, Dr Kolodziej remarks.