Cancer Patients at Risk

Will lower Medicare fees for cancer drugs administered by physicians harm patients? Yes, according to a report by the American Action Forum.

The Part B drugs are delivered “incident to” physician services, meaning they require a physician’s expertise to infuse or inject. Most commonly, these are cancer drugs used for chemotherapy and its related side effects or drugs to treat other grievous illnesses, and can be dangerous if the proper precautions are not taken in administering the drug.

Medicare Part B drug reimbursements … account for 74 percent of Medicare-covered services provided by an oncologist; this represented 70 percent of an oncologist’s revenue from Medicare. Furthermore, a recent study in the Journal of Clinical Oncology … concluded that the “economic strain combined with inadequate reimbursement limits patient access to care when practices are forced to turn away patients or go out of business.” [Reimbursement] reductions could force oncologists to turn away cancer patients or even close their doors if the practice is Medicare-dependent.

Comments (5)

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  1. Vicki says:

    I think everyone is at risk under ObamaCare.

  2. Devon Herrick says:

    Something like 14 of the 34 injectable oncology drugs are in short supply — mostly because of price controls. If Medicare cuts back on physician fees to the doctors that inject the oncology drugs, doctors willing to treat cancer patients covered by Medicare may soon be in short supply.

  3. Nancy says:

    I agree with Vicki.

  4. Brian Williams. says:

    Why fuss with reimbursement rates and price controls? According to liberals, health care should be free and universal.

  5. Marco says:

    I’m suspicious of this “turn away Medicare patients” argument.

    I’ll bet that a Medicare oncology patient has a positive contribution margin (i.e. reimbursement less variable costs > 0) when considering the total episode of care cash flows.

    That is, focusing narrowly on the ASP+6 issue is a bit of a furphy.

    I’ll also bet that oncologists have little idea of what their margins truly are anyway, and probably confuse average costs with marginal costs. Hence decisions on the stated margin are likely sub-optimal…