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Morning Consult: Medicare’s Deadly Cancer Care Gamble

May 20, 2016
Today in Morning Consult, cancer survivor and health economist Jennifer Hinkel writes about the threat posed to cancer patients by CMS’s proposed Medicare Part B drug payment model:
Who will bear the most significant burden? It will be the poorest, oldest, and least educated patients who will struggle to understand whether they and their doctors have been assigned to the “experimental arm” of this reimbursement research trial. These Medicare beneficiaries will be the unwitting subjects of a study that they did not elect to join. They will not be offered the opportunity to consent to participation, nor switch to a physician unaffected by the changes.

For the practices randomized to receive lower payments, the negative results are predictable. First, staffing will get cut to the bare minimum, risking patient safety and continuity of care. Second, offices will turn patients away, sending them to hospitals (which actually would cost Medicare more) or to other practices. In some cases, these patients will fall through the cracks and receive less or no treatment. Third, the options for treatment will be curtailed, as practices may no longer be able to afford to prescribe and prepare certain drugs.

When older medicines are used instead, initial cost may seem lower, but the side effect burden might be higher, leading to missed work days, hospitalizations, and potentially serious adverse events. Overall, this approach does not save money. Furthermore, we can hardly afford for practices to close their doors or lower capacity when we are facing a looming shortage of cancer doctors and strained cancer care capacity due to an aging population.

More and more frequently, cancer patients and survivors such as myself are seeing a cancer care system that – in a misguided effort to blame the rising cost of health care on cancer drugs – is risking patient access to the best care available.

Read the full piece here.