Under ordinary circumstances, business arrangements built around the 340B drug discount program remain shrouded in secrecy.
The complex business structure that brought together three Memphis-based entities—West Cancer Center and Research Institute, Memphis Methodist Le Bonheur Healthcare, and the University of Tennessee Health Science Center—is an exception.
That’s because their 2011 tripartite deal has resulted in a whistleblower, or qui tam, lawsuit that has generated thousands of pages of court filings that allow outsiders to see how the drug discount program intended to help the poor has the capacity to make institutions and physicians rich.
In internal discussions between the parties in the agreement, the windfall profits that poured in between 2012 and 2018 went under a curious name: a “lift.”
The most recent version of the complaint offers this account of how the deal worked:
West, a for-profit private practice, moved its cancer patients from Baptist Memorial Hospital to Methodist. On top of that, West took over the management of all cancer inpatient and outpatient services at Methodist, the complaint states. A portion of the new money was to go toward development of an NCI-designated cancer center at UT Health Sciences Center, and West took over the academic center’s oncology fellowship program.
The whistleblower suit alleges that Methodist used the discounts from the 340B program to boost its profits and use the funds to expand its foothold in the Memphis market for oncology services, paying West physicians inflated fees, reimbursing them for services they didn’t perform, paying off their business debt, and buying and refurbishing the flagship clinic that the West practice occupied rent-free through the duration of the deal.
With the lift, Methodist guaranteed that West doctors would be paid at several times the 90th percentile rate, regardless of personal productivity, the complaint states.
A junior shareholder oncologist at West received annual incomes exceeding $1 million, while senior oncologists were paid more than $3 million. According to court documents, this exceeded the Medicare reimbursement rate by 426%.
Filed five years ago, the suit contends that an alliance between Methodist and West had violated the False Claims Act, the Anti-Kickback Statute, federal prohibition against self-referral, and the Tennessee Medicaid False Claims Act—allowing the health system to capture the oncology market share, providing lavish payments to West oncologists, and costing Medicare and Medicaid more than $800 million in improper and excessive charges.
The plaintiffs are seeking treble damages.
Methodist officials described the suit as “after-the-fact second-guessing of the level of payments MLH made to West Clinic for the valuable health care services physicians provided to patients.”
In a statement, the health system said:
This compensation structure was designed by respected outside experts who determined it reflected fair market value for such services. Our payments for those services were appropriate, and MLH received the services due under the management services agreement.
We are proud of all that we accomplished through our alliance with West, which was similar to arrangements between medical specialty groups and health care providers around the country. Among other things, the partnership succeeded in creating an integrated cancer diagnosis, treatment and surgical service that not only improved cancer care, but also reduced health disparities and led to better patient outcomes for the Memphis and Mid-South communities.
West was initially a defendant in the suit, but was dismissed after paying the private whistleblowers $2.6 million, partly defraying the cost of litigation, and agreeing to provide testimony and documents to help build the plaintiffs’ case against Methodist.
The University of Tennessee Health Science Center, the third institution involved in the deal, was never a defendant.
Judge allows DOJ to join the suit
The first version of the complaint was filed on May 30, 2017, in the U.S. District Court for the Middle District of Tennessee. It was kept under seal until Jan. 6, 2020.
The “relators,” or whistleblowers, are Jeffrey Liebman, former CEO of Methodist University Hospital, and David Stern, the former vice chancellor for University of Tennessee Health Science Center.
The government can elect to join or not join qui tam cases, and if funds are recovered, the relators, are paid a percentage of the haul.
The government’s decision to join and take over is a key test of the viability of qui tam cases. The decision by the feds is important because private whistleblowers usually have limited budgets, and the government is both better resourced and able to apply greater pressure on defendants.
While the judge did not allow the government to intervene in this whistleblower case against West, the government can still file its own separate action against West. Simply put, West may not be out of the woods when it comes to these allegations.
Jeb White
In this case, the government was slow to jump in, court documents show. The U.S. Attorney’s Office said initially—in September 2019—that it was conducting its own investigation and would make the decision whether to intervene at a later date, making what amounts to a “no decision” decision, documents state.
Late in 2020, as the government appeared to be on the fence, West reached a settlement agreement with the whistleblowers, and in early February 2021 was dismissed from the suit.
But the feds apparently found the testimony and documents provided by West so compelling that they decided to join the case—and sought to add West back in as a defendant. On Oct. 8, 2021, the government filed a petition to intervene and bring West back in.
In a ruling March 11, 2022, Judge William L. Campbell of the U.S. District Court for the Middle District of Tennessee partially granted the government’s request to intervene. His ruling is bad news for Methodist, which will now face the federal government in court.
However, the ruling appears to be good news for West. The government’s move to bring the private practice back into the case was blocked by Campbell.
Writes Campbell:
The court finds that the United States has established good cause to intervene based on the new evidence obtained as a result of the West settlement. Accordingly, the United States Motion to Intervene for Good Cause will be granted. However, the United States will be permitted to intervene only as to the current defendants.
The court is fully cognizant that the West settlement was only with relators and that West was dismissed from this action without prejudice as to the United States.
Nevertheless, West has been dismissed from this action. The court does not find good cause to reinsert West at this stage of the case—to do so would not only prejudice West, but would cause undue delay in the proceedings. The United States shall file an amended complaint in intervention—limited to claims against only current defendants—within 30 days.
West CEO Mitch Graves said the practice was relieved to see the lawsuit go away.
“It is great news that the court agreed with our arguments on why West should remain dismissed from this case,” Graves said. “As we have previously stated, our patients are our top priority, and this lawsuit was a distraction to our mission of providing outstanding cancer care.”
Officials at Methodist were less happy.
“We are disappointed with the Court’s ruling to allow the DOJ to intervene in the lawsuit, but we remain confident that MLH’s affiliation with West Clinic was proper and reflected customary and legal business arrangements,” they said in a statement. “The government’s belated decision to join the lawsuit two years after it declined to do so has changed nothing about the case: the allegations of the suit are without merit, and we will continue to vigorously defend against them as the legal process unfolds.”
Observers familiar with qui tam cases said the government would be more interested in focusing on Methodist anyway. The health system has deeper pockets than West. Also, Methodist was the party that submitted the claims and received the funds from the government.
Bryan Vroon, an attorney representing the whistleblowers, declined to comment on Campbell’s ruling.
“The Justice Department is concerned that large hospitals and health systems are using illegal kickbacks to buy referrals from private medical groups,” Jeb White, president and CEO of Taxpayers Against Fraud , said to The Cancer Letter. “The deterrent effect of this case could resonate in hospital board rooms across the country.
“While the judge did not allow the government to intervene in this whistleblower case against West, the government can still file its own separate action against West. Simply put, West may not be out of the woods when it comes to these allegations.”
How the “lift” worked
Initially, in 2011, the so-called lift from the deal was projected to reach $15 million within a year, the suit states.
Under an agreement quoted in the suit, Methodist was to make “an annual payment of ‘Base Mission Support’ to UT” in the amount of “five million dollars ($5,000,000) or one third (1/3) of the cancer service line contribution margin (whichever is greater) per year.”
The agreement also stated that the “Parties will endeavor to cause the UT hematology/oncology program to receive designation as a National Cancer Institute Cancer Center.”
West’s cut was to be split between the practice partners—on top of the rates determined by the work relative value units, also known as wRVU, the complaint states. Payments to physicians are based on the work they perform, the expenses incurred by the hospital or practice, and the cost of insurance premiums.
According to the suit:
The physician leaders of West were looking for a hospital “partner” to create an outpatient cancer center called West Cancer Center. West leaders presented six primary financial requirements to Methodist’s senior executives.
First, West physicians wanted the “ability to capitalize on” the 340B Program by using Methodist’s status as a “covered entity” to acquire cancer drugs at deep discounts.
Second, West physicians demanded premium rates per wRVU for all West physicians regardless of credentials, experience or collections.
Third, West physicians wanted payments for “co-management” fees to manage the oncology service line at Methodist.
Fourth, West required that key personnel of West would be appointed to leadership positions within Methodist.
Fifth, West physicians wanted Methodist to fund all expenses, operations, offices, and staffing at the West sites to be included in the “partnership.”
Sixth, West physicians wanted a major investment in their for-profit research entity called ACORN (subsequently renamed Vector), a portion of which would be used to pay back the West physicians for their personal loans to the company.
The deal allowed Methodist to take West’s patients in-house, in effect making them Methodist hospital patients, thus getting reimbursed at higher rates and qualifying for 340B discounts.
Methodist, which didn’t provide oncology services before the deal, was suddenly able to generate substantial profits on cancer drugs—and under the arrangement with West, the health system shared the windfall with the oncologists, the whistleblower complaint states.
Under federal and state laws, physicians must be paid strictly for the services they provide and the billing they generate. Reimbursement for services is based on valuations that take into account the cost of providing the service. Therefore, a physician in New York City, where costs are high, can be reimbursed differently than one in Memphis and its suburbs, where costs are lower.
According to the complaint:
It would be brazenly illegal for Methodist to write a check each month for drug profits to the West physicians from their referrals. Consequently, Methodist devised a scheme to pay the West physicians through disguised inflated payments under the Professional Services Agreement that violated Methodist’s own valuation opinion and exceeded collections for West’s professional services by over $125 million during the years 2012-2018.
Methodist’s disguised scheme accomplished the same objective of rewarding the physicians for the value of their referrals, including lucrative chemotherapy referrals, to the Methodist-acquired cancer clinics and Methodist hospitals.
The three-party deal succeeded beyond initial expectations, the suit states.
Actual 340B profits from West physicians’ referrals were at approximately $25-30 million per year. In 2016, the lift was estimated at $63.73 million, the complaint states.
According to the complaint:
As a result of the extraordinary payments from Methodist, the shareholder oncologists at West received annual incomes exceeding $1 million and the senior oncologists at West were paid in excess of $3 million. In approximately 2014 or 2015, Methodist CEO [Gary] Shorb and CFO [Chris] McLean told Dr. Stern these income numbers for West physicians. This conversation occurred in the context of Shorb and McLean expressing difficulty finding a “fair market” valuation that would support West physicians’ incomes.
Many oncologists of West received salaries at levels that were double, triple, or four times the national 90th percentile for medical oncologists in the United States. [Each year, Medical Group Management Association (“MGMA”) surveys medical practices nationally to obtain the most recent physician compensation and production data. The MGMA Physician Compensation and Production Surveys are leading benchmarking resources for physician compensation in the United States. The annual MGMA Surveys are based on physician compensation and productivity data in the prior year. For example, the 2017 MGMA Survey reports physician compensation data from 2016.]
The national 90th percentile compensation for medical oncologists was $777,940 in 2013, $922,244 in 2014, $762,970 in 2015, $693,452.28 in 2016, and $646,226.73 in 2017 according to MGMA Physician Compensation and Production Survey Data.
One of the issues that Liebman and Stern openly opposed at executive meetings was Methodist CEO Shorb and CFO McLean guaranteeing to pay West physicians above the 90th percentile compensation levels regardless of the physicians’ personal productivity. Liebman and Stern openly questioned this arrangement because the industry norm is to pay physicians based on personal productivity.
Shorb and McLean said that defining physician compensation at any percentile was something that was just a matter of finding the “right” compensation consultants who would get the answer that Short and McLean wanted. When they found a company that agreed that paying the West physicians at exorbitant rates was “fair market value,” they admitted they would probably never be able to get such an opinion again. Shorb and McLean knew that the compensation package to West physicians was far out of the bounds of reasonable compensation.
At the beginning of the “affiliation” agreement in 2011, McLean stated that he could “alter the numbers in any way necessary” to get a deal done with the West. This statement was made by McLean in Dr. Stern’s presence and in Shorb’s presence. Shorb agreed with McLean’s statement.
Methodist was able to guarantee West oncologists with incomes above the national 90th percentile by artificially constructing multiple components to their compensation.
First, from the beginning of the alliance, the oncologists were paid a premium rate of compensation per wRVU. In April of 2011, Methodist CFO McLean told Dr. Stern that the rate would be $120 per wRVU. The actual was even higher at $145 per wRVU.
Although the agreed deal starting in 2012 had multiple components of cash income to West Clinic physicians, the rate of $145 per wRVU alone approached or exceeded the MGMA national 90th percentile compensation per wRVU in multiple years.
Secondly, Methodist also guaranteed payments to West physicians for supposedly “co- managing” the entire Methodist oncology service line. These payments increased from $3.0 million in 2012 to $3.2 million in 2013 and $4.4 million in 2014. These payments for “management” services continued in 2015, 2016, 2017, and 2018 under the 7-year term of the “alliance.” As discussed above, Methodist paid West approximately $13-16 million for inpatient management services at Methodist hospitals even though West did not perform these services.
From the beginning, Methodist CFO McLean and other senior executives knew that paying West physicians at these levels would lead to major financial losses for Methodist if revenues from their referrals were not considered. Methodist knew that nearly 50 percent of West Clinic’s patient population was insured by the Medicare Program and Methodist executives knew that the Medicare reimbursement rate per wRVU was far lower than $145 per wRVU.
The Medicare reimbursement rate per wRVU was $34.03 in 2012 and stayed between $34-35 per wRVU27 throughout the 7-year term of the alliance.
Yet Methodist guaranteed payments of $145 per wRVU to the oncologists regardless of collections. That rate was approximately 426 percent above the Medicare reimbursement rate.
Stern, the UTHC official, objected to using the profits to enrich West physicians and Methodist, but was rebuffed, the complaint states:
Dr. Stern attended Methodist Board and Finance Committee meetings in which Methodist CFO McLean stated that Methodist’s 340B drug profits were in the range of $70-100 million each year.
When Dr. Stern heard this, he proposed to the Methodist leaders (CEO Gary Shorb, CFO Chris McLean, and COO Michael Ugwueke) to “put all the 340B profits in a pot” and distribute more to UTHSC for research, indigent care, and the development to an NCI-designated cancer centerin Memphis. They refused to do this and directed Dr. Stern to silence his views.
Dr. Stern repeatedly argued that the 340B drug profits should serve the purposes of indigent care and the development of an NCI-designated cancer center. Methodist’s senior executive team—Shorb, McLean, and Ugwueke—opposed that objective and focused on using the drug profits to enrich Methodist’s revenues and West physicians’ incomes.
Here are some highlights of the complaint:
- Methodist paid West approximately $27 million in fees to manage the entire outpatient and inpatient oncology service line at the Methodist system. Methodist paid approximately $13-16 million of the $27 million in management fees to West as base management fees for inpatient management services at Methodist’s four acute care hospitals, the suit states. These management services were not expected to be performed—and, in fact, weren’t. West and Methodist, in recent filings, disputed this claim.
- Methodist paid about $7 million to acquire a for-profit contract research company called Vector Oncology (alternatively known as ACORN). Vector was owned by West physicians, who had lent the company $3.5 million to $4 million, the complaint states. Of that amount, $2 million was provided by West’s then Senior Partner Lee Schwartzberg. As part of the deal, Methodist repaid the debt. Questioning why a non-profit health system would want to own a for-profit CRO, the complaint asserts that “Methodist’s payment was inflated and a disguised kickback to reward the West physicians’ referrals to the Methodist system.”
- Methodist purchased and renovated a building at 7945 Wolf River Boulevard in the Memphis suburb of Germantown. The bill for the purchase and renovation added up to $52 million, the complaint states. From 2015 through the end of the agreement in 2018, West Clinic physicians paid no rent on the facility, the suit states.
How West cooperated with the qui tam plaintiffs
Though initially named as defendants in the suit, West saw a way to get out of the litigation by settling with Liebman and Stern, the relators.
In December 2020, just short of a year after the case was unsealed, West and the relators reached a settlement agreement, and on Feb. 9, 2021, West was dismissed from the case.
Surely, the decision to settle may have made sense at the time. The arrangement with Methodist was over; it expired in 2018. The feds had made a “no-decision” decision, which is more nebulous than a hard no, but just looking at aggregate numbers, the government joins only 20% of qui tam cases. For a cancer doc, an 80% chance of success looks like stellar odds.
A court filing by a West attorney suggests that the practice had to make an educated guess as to what the federal government would do, and based on what could be determined, the government was sitting on its hands.
Here is an account from a West filing from Oct. 22, 2021:
West’s counsel had a phone call with counsel for the United States, AUSA Kara Sweet and DOJ Trial Attorney David Cohen, on October 6, 2020.
On that call, counsel for the United States stated that “for a number of months, there’s been a no decision,” and the United States has “been passive.” United States’ counsel then went on, clarifying that “no decisions can vary,” but “this is not a case where there is an active investigation.” In discussing the United States’ “no decision,” counsel for the United States explained that “other times it functions more as a declination—and that’s kinda what’s happened here.”
Based on these comments in the midst of West’s settlement negotiations with Relators and the United States, West understood that the United States was treating its “no decision” as a declination and that it was not actively investigating West.
So, the reading of the tea leaves suggested that the feds were done, West attorneys said. Therefore, West decided to settle.
In December 2020, the relators informed the court that they had reached a settlement agreement with the West defendants. Upon settlement, on Feb. 9, 2021, the West defendants were dismissed from the case.
The relators Liebman and Stern settled the case for $1.3 million and another $1.3 million in legal costs.
According to court documents, as part of the settlement, West produced claims data and documents, and agreed to have the relators’ counsel interview West’s former CEO, Erich Mounce, former CFO Ron Davis, and physicians Brad Somer, Kurt Tauer, and Lee Schwartzberg.
This produced a more robust understanding of the arrangement with Methodist. One nifty timesaving hack to reading the Third Amended Complaint by whistleblowers is to type in the words “senior leadership” in the search bar.
This will produce every tidbit that was confirmed by West senior leadership.
All of this strengthened the case against Methodist, but it in no way precluded federal prosecutors from going after West.
Reading the new version of the complaint—the Third Amended Complaint—West attorneys disputed the claim that “West’s senior physician leadership has confirmed that West did not perform inpatient management services at Methodist hospitals over the 7-year term of the partnership.”
This was incorrect and “no such statement was ever made by any West witnesses that Relators counsel interviewed,” West’s attorneys argued.
Also, the West filing cites an email the practice’s lawyer had received from Assistant U.S. Attorney Kara Sweet, in which she described her theory of the case:
[T]he arrangement violates the AKS, as Methodist paid West remuneration—one purpose of which was to induce referrals—and that there is evidence of scienter that includes, but is not limited to, the statements [West counsel Michael] Blau made multiple times about the transaction having irreducible AKS risk and others.
(2) [W]e do not believe that the personal services safe harbor fits this arrangement for multiple reasons, one of which is that the aggregate compensation is not set in advance.
Therefore, because the arrangement violates the AKS and does not file within a safe harbor, it is, ipso facto, a criminal violation of the AKS and also violates the FCA.
On Oct. 8, 2021, the federal government filed a motion to intervene, noting that if the judge allows the intervention, it intends to add West back to the case as a defendant. The government noted that West was previously dismissed without prejudice as to the United States.
Pursuant to the terms of the settlement, to which the United States was not a party, West provided documents to Relators that had not been provided to the United States or produced in the action and agreed to make witnesses available for Relators to interview.
Following Relators’ interviews of certain current and former West executives, Relators advised the United States that they had obtained new evidence concerning West’s performance, or lack thereof, of its obligations under the Management Services/Performance Improvement Agreement (“MSA”), which Relators incorporated in the Third Amended Complaint.
In early May 2021, the United States notified Methodist that it was investigating specifically whether the MSA was a sham in light of statements allegedly made in Relators’ interviews of West personnel that, in sum and substance, West did not perform any inpatient management services at Methodist.
The United States conducted its own interviews of West and Methodist personnel in June and July of 2021, during which new and additional evidence was obtained of conduct that supported the allegations of FCA violations under the AKS. Among other information that will be detailed in the contemplated complaint in intervention, the United States obtained admissions that Methodist paid West for certain services West had not rendered under the MSA; confirmed that West lacked any time records to document or justify the amounts Methodist paid West for base management services; and learned that West sought higher fees from Methodist under the MSA based on increases in the revenues generated by West after the deal was signed.
In addition, the United States obtained new evidence that payments Methodist made to West under a Professional Services Agreement (“PSA”) were excessive as compared to the amount of reimbursement for professional services Methodist received from West physicians, such that West was paid at least tens of millions of dollars more than Methodist collected. Following these interviews, the United States immediately notified Methodist that it intended to seek the requisite approvals to intervene.
The Liebman and Stern side, of course, welcomed the move by the U.S. Attorney. Methodist and West filed motions asking the court to keep the U.S. out of the case. Methodist described the federal move as an 11th hour intervention, and West cried foul because of what it described as a change of course by the U.S. Attorney.
“There was no attempt by MLH to generate more patient referrals through excessive physician compensation—the payments for various services were agreed to after extensive negotiations based on the input and advice of outside experts,” Methodist officials said in a statement at the time.
“The lawsuit seeks to portray customary and legal business arrangements between MLH and West Clinic physicians as illegal activities, in effect penalizing the hospital for forging a successful partnership with West Clinic that did exactly what it was intended to do: create an integrated cancer diagnosis, treatment, and surgical service that improved cancer care and led to better patient outcomes for the Memphis community.”
The health system has set up a website that makes its case that the arrangement with West was appropriate.
West’s history of entrepreneurship
The entity now known as the West Cancer Center is anything but a sleepy provincial practice.
According to information on the West Cancer Center website, the practice began when William H. West, identified as formerly an NIH investigator, opened a two-room office in Memphis in 1979.
A chance meeting shortly following the opening further cemented the foundation of West Clinic. Kurt W. Tauer, MD, FACP, was a resident at a hospital in Memphis, Tennessee, assigned to a colon cancer patient of Dr. West’s. They quickly established a partnership—and friendship—that would bring Dr. Tauer back to Memphis following his fellowship in Medical Oncology at Memorial Sloane-Kettering [sic.] in New York City.
In almost predictable happenstance, Dr. Tauer’s across-the-hall neighbor in New York City and fellow resident at Memorial Sloane-Kettering [sic.]—Lee S. Schwartzberg, MD, FACP—would eventually join Dr. Tauer and Dr. West at West Clinic to form a powerful partnership of physicians dedicated to improving cancer care and overall health in the Memphis community.
This story of genesis is silent on the role of Robert K. Oldham, a former NCI official, who, together with West, formed Biotherapeutics Inc., a Memphis-based company that sold experimental IL-2/LAK treatments before the therapy was shown safe and effective in clinical trials (The Cancer Letter, April 17, 1987; Feb. 12, 1988).
The company charged $35,000 or so for treatment with IL-2/LAK. In today’s dollars, this would amount to about $86,000.
West served as the medical director of Biotherapeutics and Oldham was the company’s scientific director.
Insiders in Bethesda were shocked and appalled by Oldham’s and West’s business model of charging hefty sums for an unproven therapy that had the potential to do more harm than good, especially when administered to all comers willing to write a check.
“The thing that frightens me is that there are now people willing to sell things like this that are totally out of the realm of routine care of cancer patients,” Bruce Chabner, then director of the NCI Division of Cancer Treatment, said to the DCT Board of Scientific Counselors. “There are indications that commercial companies are trying to expand nationwide to do this” (The Cancer Letter, May 8, 1987).
Biotherapeutics raised $40 million through a public offering, and in 1987, a Wall Street analyst projected that Biotherapeutics would generate $385 million in revenues in 1992. However, IL-2/LAK failed to become a panacea, and Biotherapeutics was unable to attract enough patients.
Oldham acknowledged that the treatment wasn’t producing many cures. ‘’Most don’t respond,’’ he said, describing the Biotherapeutics outcomes to The New York Times in 1990. ‘’Most die of their disease.’’
The deterrent effect of this case could resonate in hospital board rooms across the country.
Jeb White
Apparently, IL-2/LAK was a commercial bust. In 1990, Oldham was ousted by the board, and Biotherapeutics became Response Technology Inc. He would later become a leading critics of randomized trials and a proponent of making cancer treatments commercially available after they clear phase I testing (The Cancer Letter, Aug. 5, 2005).
After failing to capitalize on immunotherapy, Response Oncology moved on to the next sure thing, starting a nationwide chain of labs supporting high-dose chemotherapy with bone marrow transplantation.
“We are attempting to define a unique concept of pharmacy and blood bank extension that would be [an] extension of local oncologists’ outpatient capability,” West, who became the RTI CEO, said to Cancer Economics, a supplement to The Cancer Letter (Cancer Economics, February 1990).
However, that business, too, ran into trouble after NCI-sponsored randomized trials showed that bone marrow transplantation in breast cancer produced no advantage over standard treatment (The Cancer Letter, April 16, 1999).
Impact on Response Technology was immediate. The number of bone marrow transplants during the second quarter of 1999 dropped to 256, compared to 333 for the same period in 1998, the company reported at the time (The Cancer Letter, Aug. 13, 1999).
The story of Response Technology and its national network of bone marrow transplantation centers was described in detail in “False Hope,” a book by Richard A. Rettig, Peter D. Jacobson, Cynthia M. Farquhar, and Wade M. Aubry, which will be republished by the Cancer History Project later this year.
After the end of the Methodist deal, Lee Schwartzberg, the senior partner, played a key role in starting OneOncology, a three-practice alliance that shares Flatiron Health’s OncoCloud platform (The Cancer Letter, March 29, 2019).
“All three of the practices were already successful on their own, but felt the need to join together to affect real change in the community oncology setting,” Schwartzberg said to The Cancer Letter at the time. “Our vision is to drive the next generation of cancer care in this country, to deliver the same type of advanced cancer care that is expected at academic institutions to all patients, no matter where they live. As people are now living longer with cancer, the need for convenient, state-of-the art care is becoming increasingly important.”
The practice also hired Axel Grothey, a colorectal cancer expert who was previously fired by Mayo Clinic for having affairs with women he mentored professionally (The Cancer Letter, May 28, June 4, Sept. 3, Sept. 24, Oct. 1, 2021).
Grothey is listed as a physician on the West Cancer Center website. The end of the three-party agreement means West is no longer handling the UTHSC oncology fellowship program, a university official said.
In March 2020, West laid off more than 80 employees.
“As with any business, West is making a major shift to streamline processes and protocols to allow the most efficient, effective and patient friendly care for our patients,” West spokesperson Julie Flanery said to Memphis Commercial Appeal at the time. “Unfortunately, as you make these type changes employees are impacted.”
Schwartzberg, the physician executive who played a key role in engineering the relationship with Methodist, is no longer chief medical officer of OneOncology, but continues to serve as a senior advisor to the company, according to the website. Also, Schwartzberg is no longer at West. A spokesperson for the practice confirmed his departure:
“Dr. Schwartzberg left in 2021 to build a program like West Cancer Center & Research Institute at the University of Nevada Reno Renown Institute for Cancer.”
