Where does access to cell therapy actually break down, and can community practices close the gap? On this episode of BackTable Tumor Board, host Aaron Lyss interviews Dr. Mike Byrne, a hematologist at Tennessee Oncology, about the challenges and successes of building an outpatient CAR T program in the community setting. They discuss the critical stakeholder relationships, operational and financial structures, and patient pathways that enable a physician-owned practice to offer cellular therapy outside a hospital system. --- Get the BackTable apphttps://www.backtable.com/app --- Timestamps 00:00 - Introduction03:50 - What Community Oncology Actually Means Here08:15 - Speed as the Differentiator: One EMR, No Repeat Workup10:40 - Look Before You Leap: Pipeline and Standard-of-Care Shifts17:30 - Why Cell Therapy Sits Outside Existing Payer Contracts20:35 - Pre-Treatment Evaluation, Insurance Vetting, and FACT Accreditation26:10 - Adding a BCMA CAR T30:30 - Infusion Day Logistics35:20 - Outpatient Monitoring Without a Six-Figure Platform39:00 - Co-Managing With the Referring Oncologist46:00 - Wrap Up and Closing Remarks --- More about this episode The conversation details how the Tennessee Oncology team aligned hospital, apheresis, and manufacturer partnerships, navigated payer arrangements outside traditional contracts, and streamlined workflows for rapid referral, insurance vetting, scheduling, and just-in-time cell shipping. The conversation explores practical decisions about when to build versus outsource services, the need for a robust patient pipeline amid shifting standards of care, and the risk management required to deliver high-cost therapies. Dr. Byrne shares how the program prioritizes access, leverages telehealth for monitoring, empowers advanced practice providers for overnight care, and adapts quickly for unique patient needs. The episode closes with real-world stories of patients who benefited from flexible, community-based care. --- BackTable Tumor Board is the go-to multidisciplinary podcast for medical oncologists, surgical oncologists, and other healthcare professionals that play an active role in cancer care. Download the free BackTable app to get early access to new episodes, cases, and courses curated by physicians in your specialty. ► https://www.backtable.com/app
