Targeting Cancer

TARGETING CANCER

The recent partnership between Ochsner and MD Anderson is the latest shift in an evolving and increasingly competitive cancer-care market in the Capital Region.

BY DAVID JACOBS

THE TWO-STORY lobby of Ochsner’s gleaming $116 million medical complex at The Grove was packed for the latest announcement to potentially shake the foundations of Capital Region cancer care.

As the afternoon sunlight streamed through the floor-to-ceiling windows, an invitation-only crowd of administrators, clinicians and well-wishers mingled and noshed on refreshments while a small musical combo sounded in the background.

Chuck Daigle, the Ochsner Health System’s CEO for the Baton Rouge market and the program’s first and last speaker, closed with the unveiling of a new brand combining two very familiar names as confetti cannons discharged behind him.

“I get to do the exciting stuff,” he said. “We’re extremely proud and grateful to announce and reveal our new logo signifying Ochsner and MD Anderson’s new partnership to create Ochsner MD Anderson Cancer Center in southeastern Louisiana.”

The University of Texas MD Anderson Cancer Center in Houston is generally acclaimed as the nation’s leader in cancer diagnosis, treatment and research. Ochsner is the center’s seventh network partner and the first in Louisiana.

The long-rumored alliance took more than two years to put together. The first phase includes two locations in Baton Rouge—Ochsner Cancer Center

– Baton Rouge (currently in the midst of a $10 million expansion) and Ochsner Medical Complex – The Grove—while the remaining five sites are in the New Orleans area and Covington.

The deal represents only the latest headline-grabbing shift in the local cancer market over the past year and a half, which also included the breakup of Our Lady of the Lake Regional Medical Center and Mary Bird Perkins Cancer Center, the Lake’s $100 million investment in its own cancer center, and Mary Bird’s partnership with Baton Rouge General.

Officials say MD Anderson’s other six partners gained market share after the deals were announced, though they didn’t provide data to support that assertion. They say integration with MD Anderson’s standards and practices elevates the quality of care, though they didn’t share any metrics to back up that claim, either.

The New Orleans-based Ochsner Health system has been expanding aggressively in recent years, perhaps too aggressively, given the recent decision to lay off almost 800 employees in Louisiana and Mississippi. But despite all the hype, when it comes to Baton Rouge market share, inpatient data shared with Business Report  suggests Ochsner may not be moving the needle very much, which raises the stakes for the latest venture.

Cancer care is only one hotly

contested element in the region’s increasingly competitive health care market. For Ochsner, recent moves also include the announcement of a pediatric “super clinic” at The Grove in 2021 and the acquisitions of Associates in Pediatrics & Adolescent Medicine, a well-known local group practice, and Louisiana Women’s Healthcare, the market’s largest OB/GYN provider.

While there is some skepticism about whether the MD Anderson partnership is much more than a marketing ploy, health care leaders say they welcome the competition. After all, every other major player in the market also is investing heavily in cancer care, in hopes of getting the biggest possible slice of a pie that is expected to grow.

MEETING THE NEED

When asked whether there’s enough cancer in this market to justify so much cancer care spending, health system officials typically respond with some version of, “Sadly, yes.”

The number of new cancer cases nationwide is expected to rise 14% this decade, according to Advisory Board, a health care consulting firm. And recent data from the U.S. Centers for Disease Control and Prevention indicates Louisiana has the second-highest rate of new cancer cases in the nation.

“The good news is the boomers are living longer,” says Stephen Mumford, chief operating officer of Baton Rouge

BIG PARTNERSHIP: Chuck Daigle, Ochsner Health System’s CEO for the Baton Rouge market, says the MD Anderson partnership could have a significant impact on local research a s well as boost the local economy.

COURTESY OCHSNER

General. “The bad news is the longer you live, the higher risk you have of developing cancer.”

Leaders of provider organizations would much rather talk about what they’re doing to fight cancer than the revenue cancer care generates. But you wouldn’t see so much investment locally and nationwide if it wasn’t profitable.

There are new therapies to provide, and as cancer becomes less of a death sentence and more of a chronic condition, patients (i.e. customers) are living longer and using more services. The payer mix is attractive, since Medicare pays well for treatment, and the returns can be reinvested in other areas of care.

“Not only does it make business sense, it aligns with our mission,” Mumford says.

Over the past 10 years, Ochsner has invested $150 million in cancer care across its system, says Dr. Aldo Russo, Ochsner’s Baton Rouge regional medical director. Without providing Baton Rouge-specific numbers, Ochsner officials say that last year the system treated more than 40,000 cancer patients from all 50 states and 28 countries.

Officials for the two companies

A possible reconciliation?

haven’t said much publicly about how the partnership model functions from a business perspective. But it’s safe to assume Ochsner hopes to capture patients who would otherwise get all of their care at MD Anderson, while MD Anderson is hoping to bolster the pipeline of local patients as Ochsner refers those best served in Houston, local experts say.

THE HALO EFFECT

Chris McKee, MD Anderson’s senior vice president for strategy and business development, says partners typically experience higher revenue and often benefit from increased research grants from the federal government and pharmaceutical companies that support clinical trials and cancer research.

MD Anderson Cancer Center in Houston sees more patients from Louisiana than from any other state besides Texas, says Dr. Welela Tereffe, MD Anderson’s chief medical executive.

But crossing state lines for care isn’t always an option, and it’s often preferable to seek treatment closer to home. Tereffe says she expects the Ochsner partnership to create

Nothing officially is in the works, but new leaders at both Mary Bird Perkins and Our Lady of the Lake say they’re open to working together again.

IN THE FALL of 2021, Mary Bird Perkins Cancer Center finalized an affiliation agreement with Nashville-based OneOncology, officially ending its partnership with Our Lady of the Lake Regional Medical Center.

The breakup of the nearly decade-long marriage had stunned leaders across the Capital Region health care sector. But while both organizations have moved on from the divorce–Mary Bird now partners with Baton Rouge General, while the Lake plans to build a new freestanding cancer center–their leadership has changed, and members still talk informally.

So, could the relationship be rekindled? It’s not out of the question, according to current leaders on both sides.

“Jonas [Fontenot] and I have had multiple conversations,” says OLOL President Chuck Spicer of Mary Bird’s CEO. “If we can find a way to begin our relationship again, even if that way is smaller, we’re going to find it.”

Local health care leaders frequently discuss ways to work better together, Fontenot says. So just because officials with the Lake and Mary Bird have conversations doesn’t mean a big announcement is imminent.

noting its current relationships with Baton Rouge General and Woman’s Hospital.

“The sky’s the limit,” Fontenot says, when asked what a new partnership with the Lake might entail. “I wouldn’t place any arbitrary barriers in the way of a collaboration.”

For a deep dive into the Mary Bird Perkins-Our Lady of the Lake split, check out the cover story in the November 2021 issue of Business Report.

—David Jacobs

EVERYONE WINS: Jonas Fontenot, CEO of Mary Bird Perkins Cancer Center, says having the MD Anderson brand attached to the Baton Rouge market could prompt patients to more strongly consider seeking care from a local provider.

“If we can find a way to begin our relationship again, even if that way is smaller, we’re going to find it.”

CHUCK SPICER, President, Our Lady of the Lake Regional Medical Center

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A Cancerous Problem

a “halo effect” by combining two highly respected brands.

“Our number one priority is eliminating cancer,” she says, when asked about Baton Rouge’s proximity to Houston. “The fact that we happen to be adjacent to one another is an added plus.”

Daigle, Ochsner’s local market leader, also touts the potential for more clinical research in Baton Rouge, which could have positive spinoff effects for the economy as well as local patients.

“The goal would be to have as many patients treated locally as possible,” he says. “Family support is truly important for healing.”

The organizations will remain “separate and distinct,” Tereffe says, with no job losses or executive transfers tied to the partnership. No MD Anderson providers will relocate to Baton Rouge, though technology enables easy consultation, officials say. Each of Ochsner’s cancer physicians has been certified by MD Anderson to clinically practice as part of the co-branded program, and Ochsner MD Anderson doctors will have the opportunity to become adjunct members of the MD Anderson faculty.

Officials plan to expand the partnership beyond the seven south Louisiana locations already announced, which requires detailed

program assessments and significant work in care coordination and infrastructure development, says Dr. Brian Moore, Ochsner MD Anderson Cancer Center’s medical director.

“We are working with MD Anderson to certify additional Ochsner sites and that process can take up to two years,” Moore says.

A STABILIZING FORCE

Teri Fontenot, who was CEO at Woman’s Hospital for 23 years before stepping down in 2019, stayed on the job a year longer than she had planned to stand up the Woman’s Cancer Pavilion, which is essentially a one-stop shop for diagnosis, treatment and survivorship resources created and maintained in partnership with Mary Bird Perkins Cancer Center and Our Lady of the Lake.

“I felt strongly that we shouldn’t be duplicating services that were already offered in the community and were being done well,” she recalls.

Fontenot says duplication increases costs for patients. Basic economics suggests competition in a marketplace reduces costs, but that’s not the case with health care, she says.

Woman’s ranks No. 121 on Newsweek’s 2023 list of the nation’s

TOP CANCERS IN EAST BATON ROUGE PARISH, 2015-2019

Prostate

Breast (Female)

Lung and Bronchus

Colon and Rectum

Melanoma of the skin

Kidney and Renal Pelvis

Corpus and Uterus, NOS

*Top 10 sites shown unless case counts are too small to display for less common cancers. Source:

top 175 cancer hospitals, the highest ranking for any local facility. Our Lady of the Lake is No. 140, the only other Capital Region hospital ranked, while MD Anderson in Houston is No. 1. Rankings are based on a nationwide online survey, hospital quality metrics and patient experience, Newsweek says.

Woman’s served 1,040 cancer patients last year, 692 of whom were breast cancer patients, a spokesperson reports. Focusing exclusively on female patients, and breast and gynecological cancers specifically, drives high-quality outcomes and patient satisfaction, CEO Rene Ragas says.

But even while touting the advantages of cooperation, Ragas still says fierce competition to provide the best possible care is a good thing.

“Ultimately, the patient is the one who benefits,” he says.

While it’s not unusual for local cancer patients to get some or all of their treatment at MD Anderson, it’s not as common as you might think, says Mumford, the Baton Rouge General COO. In the last five years, BRG has had only 32 patients (out of almost 8,000, including 1,540 in 2022) go out of state for part of their care, a spokesperson says, though that number would not include patients who never

sought care from BRG in the first place.

The Ochsner-MD Anderson arrangement is in some ways similar to Baton Rouge General’s partnership with Minnesota-based Mayo Clinic, ranked as the top general hospital in the nation by U.S. News & World Report. BRG patients can get a second opinion from a Mayo Clinic physician within three days, Mumford says. If an expert from the famous name-brand, out-ofstate hospital recommends the same plan as their local doctor, that might be all the patient needs to hear to get treatment locally.

As the market shifts, BRG has strengthened its hand by partnering with a cancer care brand the Capital Region has trusted for more than 50 years. According to a recent survey by National Research Corporation, 27% of Baton Rouge patients prefer Mary Bird Perkins for cancer treatment, while BRG comes in second at 10%.

The head-to-head comparison between Mary Bird and the hospital systems is imperfect—the former focuses on outpatient treatment— but the data still suggests that Mary Bird (which a spokesperson says served 5,673 new patients in the Capital Region last year) and BRG combined are preferred by more than one-third of local patients,

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while other providers are in single digits.

“Given what we’ve accomplished over the past 18 months, we’re definitely a stabilizing force [in the local marketplace],” Mumford says. “And we’re not done. We have major plans to continue to grow with Mary Bird Perkins.”

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While local providers compete for local patients, the MD Anderson brand has the potential to grow the local market, says Jonas Fontenot, Mary Bird’s CEO. Patients who otherwise might have only considered going to Houston may take a harder look at what’s available in their own backyard, which could benefit local providers who aren’t part of the partnership, he suggests.

If Ochsner brings more clinical trials to Baton Rouge, that would bring additional expertise and resources to the region, which could have spillover benefits for other providers. But Fontenot cautions that the resources needed to support large trials are not easily portable or scalable.

Fontenot, who trained at MD Anderson, says officials there have tweaked the partnership model as some partners achieved more economic success than others. Time will tell if the newest partnership will succeed.

“MD Anderson obviously has

a very prominent, well-known and well-earned reputation,” he says. “[But] there’s only one MD Anderson, and that’s in Houston.”

Our Lady of the Lake is planning an 80,000-square-foot, $100 million-plus cancer center at the intersection of Hennessy Boulevard and Brittany Drive. The first phase of construction, which will house imaging and therapeutics, is expected to take a year or so once the board approves moving forward, likely this fall.

“A lot of the investment we’ve already made,” says Chuck Spicer, OLOL’s Baton Rouge market president. “It’s a consolidation of all those services into a building.”

When it comes to cancer care, Spicer names a few areas where the Capital Region could use more talent. Colorectal cancer doctors and surgeons are extremely busy, for example, in part because they’re treating cancers that wouldn’t have been caught 10 years ago, and no one is doing bone marrow transplants here, he says.

OLOL serves patients from every parish and could cast an even broader net through more virtual visits, making referrals easier, and growing its partnership with LSU, Spicer says.

“It’s easy to get sucked into the competitive side of cancer,” Spicer says. “Our goal is not to beat XYZ health system. Our goal is to help beat cancer.”

MULTIPLE PARTNERS:

LSU President William Tate and LSU Health are partnered with LCMC Health in a bid to obatain an NCI designation. The system is also involved with Ochsner in the multi-university Louisiana Cancer Reearch Center.

An important quest

Becoming Louisiana’s first NCI-designated cancer center would open the door for more research dollars and a higher level of care in the state.

WHEN LSU PRESIDENT William Tate was on the faculty at Washington University in St. Louis, his father was diagnosed with cancer of the esophagus and sought treatment at the university’s cancer center, which is one of 54 National Cancer Institute-designated comprehensive cancer centers in the country. His father received care meeting the highest evidence-based standards tailored to his needs and experienced a period of remission, Tate says.

“My father got a chance to see my daughter play volleyball, and he was so excited to do that,” he says. “I’m 100% confident that he got extra time in his life because the quality of care was very high.”

The quest to bring Louisiana its first NCI-designated cancer center, which could open the door to more federal grants and raise the level of care in a state, dates back to at least 2002, when the Legislature brought LSU and Tulane together to form the Louisiana Cancer Research Center. Xavier University and Ochsner Health have since been added to the consortium.

Last year, Tate announced a separate effort, led by LSU Health but with New Orleans-based LCMC Health as the clinical partner. Officials say the initiatives are complementary, not competitive.

“There is no single entity in Louisiana that can successfully compete for NCI designation today,” says Dr. Brian Moore, medical director with Ochsner MD Anderson Cancer Center.

NCI only allows for one academic and one clinical entity in the initial application, though Tate hopes to include Our Lady of the Lake, LSU’s Baton Rouge clinical partner, in the follow-up application. He says “the totality of the LSU family” is part of the effort.

LSU is currently in the hunt for up to 12 biomedical science allstars with National Institutes of Health research grants. At a minimum, LSU needs $10 million in annual NIH cancer-focused grant funding, compared to the $5.5 million it has now, among other factors, Tate says.

The process will take at least five years, but the effort sends a message that Louisiana is serious about attracting and retaining the best and most promising clinicians and researchers, he says.

“The fight to get there has the potential to save lives all the way through the process,” Tate says.

—David Jacobs

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