The oncology service line has been undergoing significant innovation. From immunotherapies to genomic tests, patients and providers are seeing better survival rates and optimizing treatment pathways in a variety of cancers. In addition, government programs like 340B and the Oncology Care Management models (OCM) make the economics of running a small oncology practice more challenging than being part of a larger health system.

In the context of these changes, providers are weighing the value of leaving their practices to align to dominant healthcare systems, effectively giving up control to the system.

In a 2016 survey conducted by Navigant among oncologists and hematologist-oncologists, 55% of oncologists reported that they are already employed by either a hospital or a health system or a group practice. A significant minority (45%) considered themselves independent, or “not employed,” by a health system or group practice. However, at least one-quarter of the independent group plan to either integrate with a hospital or combine with another practice in the next 2-3 years.

Chart 1: Current and future employment structure of US oncologists (n=79)

The trend in employment seems to be driven by two complementary forces:
• Health systems’ desire to employ oncologists
• Oncologists desire to be employed

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