Investor-Facing Market Study on Oncology Services

Summary

We supported a scaled oncology provider group in educating prospective investors on its future performance by conducting a comprehensive assessment of the legislative and regulatory health policy environment affecting its market outlook. Specifically, we assessed the impacts of changes in that environment such as Inflation Reduction Act (IRA) reforms (e.g., likelihood of drug negotiations), 340B drug discount program changes and the impact changes may have on the provider landscape, and participation in the Center for Medicare & Medicaid Innovation’s (CMMI) Enhancing Oncology Model (EOM). Our research and analysis provided objective, third-party insights to prospective investors, who ultimately chose to make a material investment in the client.

Client Type

Oncology service provider group

Challenge

In anticipation of its prospective sale, a scaled oncology practice group sought our assistance to conduct a market study of the core regulatory and payment issues affecting the medical oncology services market. The client aimed to educate prospective investors on potential impacts of the IRA and the implementation of novel Medicare payment demonstrations for delivery of oncology services, in particular the EOM, on its future growth prospects.

Solution

We completed an in-depth legislative and regulatory assessment of how the implementation of the IRA would impact select oncology drug products that are commonly utilized in oncology services and characterized the regulatory outlook for the 340B drug discount program to determine how those dynamics may influence competition between hospitals and community oncology providers in administering oncology treatment services. We also gauged how the practice group’s approach to value-based oncology care aligned with the forthcoming EOM, demonstrating the client’s likelihood of success participating in the EOM by adapting its previous strategies that resulted in successful Oncology Care Model performance. We helped to educate buyers about the client’s past success participating in Medicare demonstration models for performance in oncology, validating the client’s strategic position for achieving success under risk-based contracting scenarios.

Outcome

Based on growth projections informed in part by our regulatory and market assessment, the client demonstrated its value to prospective investors and was successfully acquired by a private equity sponsor and its strategic partner.

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