Medicare cuts damage cancer care, group finds
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Changes to Medicare, the federal health plan for the elderly, may be damaging important aspects of cancer care in the United States, according to a study released on Thursday.
They found that many centers offering cancer care are losing money on patients and predicted that some may be forced out of business.
The Community Oncology Alliance, which commissioned the report, said the findings have implications for healthcare reform in Congress but also require immediate attention from Medicare.
“For some patients, particularly in rural areas, it means the infusion clinic that is close to them will close,” the group’s Dr. David Eagle said in a telephone interview.
Cancer is diagnosed in 1.3 million Americans every year, according to the American Cancer Society.
The alliance, which advocates for oncologists outside of big hospital centers, has been waging a public relations war to complain that changes to Medicare’s reimbursement plans have inadvertently cut payments to cancer specialists.
The group commissioned Washington-based consulting group Avalere Health to survey community oncology practices, which the group says treat 85 percent of cancer patients in the United States.
They analyzed answers from 76 oncology practices representing 680 providers, which Avalere admitted may not be representative of all community oncology practices. The survey only looked at infusion services—the delivery of chemotherapy—not surgery or radiation treatment.
Eagle, of Lake Norman Oncology in Mooresville, North Carolina, is presenting the Avalere study at his group’s annual meeting this weekend in Scottsdale, Arizona.
It found Medicare pays for 56 percent of the expenses of delivering chemotherapy.
“Under the rules, this 56 percent will go down by 20 percent to 45 percent in 2013,” said Ted Okon, executive director of the Alliance.
He said the average practice was losing $500,000 a year. In many cases, patients with private insurance are charged more to make up the difference.
BUSINESSES THREATENED
Dr. Shannon Penland of Jefferson Medical Associates in Laurel, Mississippi is one of those affected.
“The busier I got, the more money we lost,” Penland said in a telephone interview. “After my first eight months here, the practice had accrued almost $300,000 in debt.”
Penland, the only oncologist in her group, said the other specialists were having to pay her debts. Treating cancer threatens the entire operation.
Much of the expense comes because cancer treatment requires many more staff than simple primary care, Penland said.
“Each internist has a nurse. They have one other person to help them,” she said. But she has five staff to help her in handling the average 55 patients a day her clinic treats: two nurses, someone to mix the chemotherapy drugs, a nursing assistant and a nurse-practitioner.
“It is a small community but we have a lot of patients with cancer,” said Penland, whose practice is about 45 minutes from Hattiesburg, Mississippi, the nearest town of any size.
Penland said she is considering leaving oncology and going into internal medicine.
Lindsey Spindle, a spokeswoman for Avalere Health, said the changes threaten more than cancer care.
“Medicare payment reductions are poised to affect a broad range of medical specialties, including medical oncology, in an environment where fiscal resources are being carefully scrutinized by Congress and the Administration,” she said.
By Maggie Fox, Health and Science Editor
WASHINGTON (Reuters)
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