Cancer Clinics Warning Chemo Patients To Go Elsewhere
Cancer doctors across the country are warning thousands of chemo patients they may have to turn them away.
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Since: Dec 05
#1 Apr 7, 2013
The nation's oncologists at community-based oncology practices were delivered a stern message last year to either learn to deliver care at lower costs or watch the government and insurance companies impose limits. Congress has just fired a shot over the bow.
Aside from sequestration, oncology has become a focal point in the health care cost control debate because its claims are rising faster than other specialties, according to The Fiscal Times last October.
Most of these private practices pay their bills by selling chemotherapy treatments and charging Medicare and insurers a mark-up on the wholesale cost of cancer drugs - 6 percent in the case of Medicare and 20 to 40 percent for private insurers.
One large healthcare company is already experimenting with agreed-upon treatment strategies that would get rid of the cost-plus model because that model provides a powerful incentive for oncologists to use not only more drugs, but the most expensive drugs.
And a proposal from academia suggests that Medicare and insurers could shift to a system where oncologists are paid for episodes of care (a bundled payment) rather than fees for the various services.
Besides eliminating the incentive to order duplicative or unnecessary tests, imaging and office visits, it would encourage physicians to use the most cost-effective chemotherapy regimens that deliver comparable results.
It's not that sequestration is a surprise to community oncology.
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