Latest / Becker’s Healthcare Podcast / The Future of Oncology Strategy, AI and CMS Reform with Jordan Johnson

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The Future of Oncology Strategy, AI and CMS Reform with Jordan Johnson · Becker’s Healthcare Podcast

• 0:02
  - Every health system executive right now is being
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  - asked to do something that has no useful
• 0:06
  - precedent,
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  - make durable technology decisions in an environment that
• 0:10
  - looks meaningfully different every six months.
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  - The pace isn't slowing,
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  - the vendor landscape isn't getting simpler, and the
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  - cost of missteps keeps rising.
• 0:19
  - Becker's eleventh annual IT and Revenue Cycle Conference,
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  - The Future of AI and Digital Health, exists
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  - for exactly this challenge.
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  - Here, you'll find more than 2,500 executive level
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  - attendees,
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  - 600 plus speakers, and four days of sessions
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  - built around the questions leaders are actually wrestling
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  - with.
• 0:37
  - How to scale AI responsibly,
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  - how to protect increasingly complex systems,
• 0:42
  - how to wring more performance out of the
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  - revenue cycle, and how to make tech investments
• 0:46
  - that hold up over time.
• 0:48
  - Join us September fourteenth through the seventeenth at
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  - the Hilton Chicago.
• 0:53
  - You can register on our events page at
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  - beckershospitalreview.com
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  - by clicking on the events tab in the
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  - upper right.
• 1:01
  - This is Scott Becker with the Beckers Health
• 1:03
  - Care Podcast.
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  - We're thrilled to be joined by a a
• 1:06
  - brilliant leader. We're joined today by Jordan Johnson
• 1:09
  - of Bridge Oncology.
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  - Jordan's gonna talk to us about trends he's
• 1:13
  - watching. I would see that oncology space is
• 1:15
  - so challenging right now and a lot more.
• 1:17
  - Jordan,
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  - take a moment and tell us a bit
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  - about yourself and and what you do.
• 1:22
  - Oh, you bet. Scott, pleasure to be here,
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  - and talk about some of this with all
• 1:26
  - the chaos that we have going on. But
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  - my name is Jordan Johnson, and I'm the
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  - cofounder of Bridge Oncology
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  - along with doctor Arpit Chhabra, but started my
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  - career clinically
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  - almost twenty I guess it's been twenty one
• 1:37
  - years ago, as a radiologic technologist doing HRACT
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  - and then as a radiation therapist.
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  - Then moved on into the executive leadership roles
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  - for the oncology service line, revenue cycle, compliance,
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  - and now health care law. But today, our
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  - team really works with a broad spectrum. We
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  - work with hospitals, health systems.
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  - We work with large health care attorney firms.
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  - We work with
• 2:00
  - advisors, and some of the big advisors that
• 2:02
  - most people know by name,
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  - on the clinical, operational, and financial performance
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  - of healthcare in general, but with a specific
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  - focus
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  - in oncology.
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  - And our focus really at Bridge has been
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  - quite unique because we've combined all of this
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  - together
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  - to where we didn't wanna be just another
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  - healthcare consulting company that writes reports, gives you
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  - a how to manual, and then moves on.
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  - But we actually are able to build things
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  - and then execute,
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  - execute. So that really, really points
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  - out the expertise of our staff. I mean,
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  - we onboard and have physicians. We have data
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  - analysts. We have forensic accountants, health care attorneys,
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  - pharmacists, infusion leaders, admins.
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  - And so you put all that together, and
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  - you really can do something
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  - pretty unique.
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  - But our mission has been
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  - pretty narrowly focused, meaning,
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  - we wanna protect, the current access to to
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  - high quality cancer care and make sure that
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  - it's there close to home for patients.
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  - And this has really come under fire under
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  - the past few years as the administration
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  - looks to to change things up, but we
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  - wanna redefine
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  - a completely failed model. We know the current
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  - model,
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  - RFK has talked about this, Oz has talked
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  - about this.
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  - We know that the current model is broken,
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  - that it's failed,
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  - and we can't just put Band Aids on
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  - anymore, but we have to redefine it. And
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  - so,
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  - we still believe that, you know, we have
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  - to preserve,
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  - some of the fundamentals,
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  - operationally,
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  - financially
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  - to ensure that things continue to move forward
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  - and survive. So,
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  - that's a little bit about me, and I
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  - hope that helps a little bit.
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  - No. Thank you so much. And and talk
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  - a little bit about you you talked about
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  - doctor Oz's perspective,
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  - What trends are you watching in oncology currently?
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  - And what trends are you watching in health
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  - care currently?
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  - Absolutely. I mean, we're coming off the last
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  - two weeks where we or really three weeks
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  - where we saw, you know, the CMS proposed
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  - rules,
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  - both eighteen fifty on the OPPS,
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  - hospital side, and then, of course, last week,
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  - eighteen forty eight on the MPFS side. And
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  - I think a lot of people were
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  - I I won't say we were shocked. We
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  - knew all this was coming. The writing's been
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  - on the wall for a while, but I
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  - think,
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  - it's really the biggest transformation in health care
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  - in decades. And I think that's what we're
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  - looking at is most people tend to look
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  - at CMS proposals and say simply, you know,
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  - what are my rates gonna look like next
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  - year? How much am I getting cut? How
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  - much am I getting paid? And I think
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  - that's been the wrong question. I think the
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  - better question is, what is CMS signaling? What
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  - are they trying to tell us? And so,
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  - what we're really watching and looking forward forward
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  - thinking about is, you know, when I look
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  - at the 2027 proposal, we see several major
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  - signals.
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  - I think we're seeing, a signal on the
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  - move towards the total cost of care rather
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  - than a volume based reimbursement, which we've said
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  - for decades for fee for service.
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  - I think they made it very clear that
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  - AI is becoming now a reimbursable clinical tool,
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  - but only if it's governed, measurable, and creates
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  - actually documented value.
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  - I think we're also seeing increased attention to,
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  - program integrity, documentation, and operational accountability.
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  - And then the biggest thing, I think, that
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  - everybody sees is it's CMS continuing to march
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  - towards,
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  - site neutrality.
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  - The proposal to expand,
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  - physician fee for service, you know, equivalent payments
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  - for certain imaging service performed
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  - and accepted off campus hospital outpatient departments
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  - isn't just about imaging reimbursement. It's really another
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  - indication that CMS is becoming less willing to
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  - pay different rates simply because care is delivered
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  - in a hospital only setting. And I think
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  - that philosophy has implications,
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  - you know, well beyond imaging,
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  - and will continue to reshape the outpatient strategy.
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  - And then, you know, the hot topic, I
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  - think, for the and everybody is the three
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  - forty b reform. I mean,
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  - again, been talked about for years. So this
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  - reimbursement change of three forty b really sent
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  - a pretty powerful message for years. You know,
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  - the health systems have relied on the pharmacy
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  - margin
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  - to subsidize other other service lines, you know,
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  - behavioral health, wound care,
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  - and even recently some oncology services. And so
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  - I think CMS now says, hey.
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  - You know, we're looking and signaling that, those
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  - cross subsidization models
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  - may not be sustainable indefinitely. I think organizations,
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  - you know, are gonna need to understand what
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  - the true economics are,
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  - for each each service line rather than relying
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  - on these historical
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  - reimbursement advantages.
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  - And so you mentioned oncology specifically.
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  - All of those, I think, we're gonna see
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  - significant
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  - migration
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  - of certain services, infusion, theranostics,
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  - imaging, radiation oncology.
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  - They're all gonna continue to evolve as reimbursement
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  - changes,
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  - alter where the where the care can be
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  - delivered
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  - most efficiently and effectively.
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  - And I think those that optimize the operational
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  - cost, the governance,
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  - and patient access will be positioned far better,
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  - than those relying on the current, you know,
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  - the legacy reimbursement structures.
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  - Thank you. And do you wanna take a
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  - moment on what you're most focused on and
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  - excited about currently?
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  - When it's through the end of the year
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  - through next year, what are you most focused
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  - on and excited about?
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  - I'm excited about it all,
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  - right now. Thank you. I'm proud that we've,
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  - you know, grown from from being,
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  - primarily in the in the infancy stages of
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  - a company,
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  - as a really a radiation oncology company to
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  - more of,
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  - oncology strategy, health policy
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  - in that, legal health execution firm.
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  - We've expanded those,
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  - into infusion operations. I'm excited about that.
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  - Our pharmacy strategy, Theranostics,
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  - AI governance,
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  - you know, it's not enough just to react
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  - to these reimbursement changes. We wanna help people
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  - understand where policy's heading,
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  - before those changes actually arise.
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  - And I think, you know, over the last
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  - year,
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  - we've helped
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  - organizations, obviously, recover significant revenue,
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  - improve a lot of their operations, strengthen their
• 8:00
  - compliance programs, and prepare for some of these
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  - changes.
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  - I mean, for example, you know, radiation oncology
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  - underwent the largest CPT code change that is
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  - still a nightmare today that went into effect
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  - January 1. And,
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  - you know, quite frankly, we weren't prepared for
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  - it.
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  - Policy wasn't prepared for it. Governing societies and
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  - bodies
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  - definitely,
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  - were not prepared for it and didn't prepare
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  - a lot of the payers, so we're still
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  - seeing fallout from that. So it's making sure
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  - that we're way ahead of the game. And
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  - to do that, you gotta enlist others. You've
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  - got to line side by side. You can
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  - no longer be, you know, the person or
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  - the company that says, hey.
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  - Just a few of us can do it
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  - all. So I'm excited about the work that
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  - we've lined alongside.
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  - I mentioned Sanjay and Doug, Sanjay Joneja, Doug
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  - Flora,
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  - with the Tensor Black team, which is, you
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  - know, we're just exploring how does
• 8:52
  - AI how can we move beyond just another
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  - point solution
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  - and become really a trusted infrastructure that actually
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  - helps providers,
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  - make better operational, financial, and clinical decisions.
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  - And I think the opportunity isn't just building
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  - AI. It's building AI that aligns with all
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  - of these policies and governance,
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  - and that's where I believe things are, you
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  - know, positioned to better succeed.
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  - And I think,
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  - to kind of add to that, I think
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  - what excites me most is I don't think
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  - we've even reached the beginning of what's possible
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  - and where this stuff is going. I think
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  - there's a lot of exposure right now. Meaning,
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  - I think there's a lot of people that
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  - have, you know, we we all heard the
• 9:29
  - term fake it till you make it. And,
• 9:31
  - unfortunately, in this landscape, now that the screws
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  - have tightened,
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  - there is no fake it till you make
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  - it. So I think health care is entering
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  - a period where reimbursement technology, policy, operations
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  - are converging much faster than ever before. So
• 9:44
  - organizations that understand those intersections
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  - will lead to the next decade of where
• 9:49
  - CMS is positioned as for transformation. And so
• 9:52
  - I think that's why you really have to
• 9:54
  - have the people that understand this. And the
• 9:55
  - people that understand it best are the people
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  - that can move fast and align with others
• 9:59
  - in the space that understand this too.
• 10:02
  - Jordan, what a pleasure to visit with you.
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  - One more question.
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  - Single piece of advice for entrepreneurs, for founders,
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  - what advice would you give? Oh my gosh.
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  - That's that's a great question. I wish I
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  - I wish I had this, twenty one years
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  - ago, and somebody had told me this. Of
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  - course, I don't know if they could've, foreseen
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  - everything that was gonna change and happen in
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  - health care. But what advice would I give
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  - either a start up or evolving leaders? And
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  - I would tell leaders to become students of
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  - the system,
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  - not just a specialist in a department or
• 10:33
  - a focus.
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  - Health care has become way too interconnected
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  - for finance to operate independently from clinicians
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  - or compliance to operate independently from technology.
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  - So I think the leaders who are actually
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  - gonna thrive over the next decade will understand
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  - how all of those pieces fit together, and
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  - I would encourage those leaders
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  - to spend more time asking why than asking
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  - what. I think it's easy to measure the
• 10:56
  - metrics. It's much harder to understand
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  - the system that's actually producing those metrics.
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  - So that's probably what I would leave them
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  - with.
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  - Love that. I absolutely love it. Jordan Johnson,
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  - what a pleasure to visit with you today
• 11:09
  - on the Becker's Healthcare podcast.
• 11:11
  - Thank you for taking the time with us.
• 11:12
  - Thank you very, very much. You bet.