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Cancer Docs Weigh in on Medicare Part B Demo

September 28, 2016
This week, American Society of Clinical Oncology (ASCO) President Daniel Hayes, MD and CEO Clifford Hudis, MD shared their thoughts in The Hill on how “We can do better than Medicare Part B demo.” At the forefront of oncology, they remind us that we are living in remarkable times of real progress – treatment options are ever-improving as is the number of cancer survivors. However, the experimental nature of Medicare Part B demo poses a threat to patients most in need of new treatments:
The Administration’s Medicare Part B proposal is not the solution. Instead, it would threaten access to high-quality cancer care for millions of Americans living with cancer. The demonstration addresses only one narrow piece of the escalating cost of clinical care, and the Center for Medicare & Medicaid Services (CMS) proposal misses a real opportunity to advance quality and outcomes for Medicare beneficiaries.

Under the Medicare Part B demonstration, doctors could see their reimbursement for a patient’s needed medicine end up being less than they originally paid for it. Physicians would then be faced with a stark choice of either providing the treatment at a loss or referring their patients elsewhere to receive the treatment. Patients could then be forced out of smaller offices or rural settings to higher-cost facilities – and as the authors note, such an outcome could increase Medicare costs by approximately 30 percent, despite CMS’s claim that the demo will be budget neutral.

This demo could also have other unforeseen consequences for those with the most to lose in this scenario – the patient:
The CMS proposal lacks quality protections, monitoring provisions, and other safeguards typically required to protect clinical trial participants—creating substantial risks for Medicare beneficiaries who can't opt out.

As Hayes and Hudis urge this proposal not move forward, they suggest “we can do better than Medicare Part B demo” and continue to grant patients access to live-saving treatments with legislation that supports “comprehensive, value-based payment reform for high-quality care.”

Read the full op-ed here.