Proposed Medicare Cuts Threaten Cancer Care for Seniors

Community Oncology Alliance Submits Comments to CMS Regarding 2012 Physician Fee Schedule

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Sep 01, 2011, 11:01 ET

WASHINGTON, Sept. 1, 2011 /PRNewswire/ -- The Community Oncology Alliance (COA) submitted comments to the Centers for Medicare and Medicaid Services (CMS) regarding proposed changes to the 2012 Physician Fee Schedule, which the organization warns could irreparably damage the U.S. cancer care system.

COA is calling on CMS to prevent the Physician Fee Schedule cuts and the recently appointed "Super Committee" to prevent further Medicare cuts to cancer care and to address the 29.5% sustainable growth rate (SGR) cuts to all physicians, scheduled to take effect on January 1, 2012.

"These proposed cuts to cancer care will create the perfect storm," said Ted Okon, executive director of COA. "Slashing reimbursements to cancer care began in 2004 and is now only accelerating. Between the new proposed physician fee cuts, GPCI cuts and the uncertainty of potential SGR cuts, oncology may be facing an almost forty percent reduction in January. This is simply unsustainable and could break the back of our country's cancer care system, which is already in crisis."

The comment letter addressed multiple concerns, including undervalued services under the Physician Fee Schedule; the uncertainties caused by the deficit committee and the looming SGR cuts; as well as the effects of proposed changes to Geographic Practice Cost Indices (GPCIs), which would result in additional "stealth" cuts in reimbursement to cancer care.

"We have watched practices shut their doors and the market shrink. Now we are seeing drug shortages exploding. This is emblematic of a delivery system in crisis," said David Eagle, M.D., president of COA and partner in Lake Norman Oncology, Mooresville, North Carolina. "In this environment, many physicians are finding it almost impossible to provide care to all their patients."

COA submitted a solution -- the Patient-Centered Oncology Medical Home Demonstration -- to the Center for Medicare and Medicaid Innovation (CMI) in March. This solution would enhance quality and control costs; however to date COA has heard no response from CMI.

Over the past few years, the U.S. has seen the effects of cuts to reimbursement for cancer care. Oncology practices are closing and providers are consolidating; now, the rate of cancer drug shortages is rapidly increasing. These factors impact the ability of physicians to provide care and patients to obtain care.

"Our solution is intended to transform the cancer care delivery system to optimize both the quality and value of care delivered, based on this model that maximizes care coordination and efficiency, which is exactly the intent of health care reform," continued Dr. Eagle. "This model has been piloted successfully by a leading oncology practice, and we hope to see it implemented on a national scale."

A copy of the comment letter, complete with a full overview of the potential cuts, can be found at the organization's website at www.communityoncology.org.

About Community Oncology Alliance (COA)

Formed in 2003 in response to the Medicare Modernization Act, COA is a non-profit organization dedicated solely to community oncology. COA was founded by community oncologists to advocate for patients and providers in the community oncology setting, where four out of five Americans with cancer are treated.

Currently, COA is working with the Congress in providing proactive solutions designed to protect the viability of the nation's cancer care delivery system and patients' access to quality, affordable cancer care. The cancer death rate in the U.S. has declined due to earlier detection, the quality of treatment, and the accessibility of cancer care. However, according to the American Cancer Society, men still have an approximately one in two lifetime risk of developing cancer, with a risk of one in three for women. For more information, please visit www.communityoncology.org.

SOURCE Community Oncology Alliance