While the war on health care reform continues, there is another battle raging now: the Center for Medicare and Medicaid Services (CMS) will cut payments further starting in 2010 for each of the major components of cancer diagnosis and care -- chemotherapy, consultations, diagnostic imaging and therapeutic radiation. Starting in January, payment for the administration of life-saving cancer drugs will be cut by 5 percent, with further cuts increasing to almost 20% by 2013. A disaster in cancer care delivery is imminent.
These drastic reductions in reimbursement from Medicare will undermine the quality and the availability of medical care for cancer patients in this country. More cuts to Medicare, the federal health program for the elderly that provides care for 45% of cancer patients, will jeopardize access to cancer care only rivaled by the crisis of the underinsured.
Cuts in Medicare reimbursement to oncologists for cancer drug administration have occurred every year since 2004, totaling more than a 25 percent decrease in reimbursement from 2004 to 2009. Estimates are that about half of the essential services provided by community cancer facilities are currently not even reimbursed at all. Making this bad situation worse, CMS is also scheduled to cut physician-related Medicare payments for all physicians by an additional 21.2 percent effective Jan. 1, 2010.
While many suspect this is merely a case of already overpaid doctors wanting a bigger slice of the pie, I can only share the challenging situation of my own practice. We are losing money on nearly half of the cancer drugs we administer.
If the amount is small, we are able to treat the patient, but for significant losses and for patients on Medicare alone, we are now forced to refer them to local hospitals, some of which have told us they lack the capacity to care for them.
We are willing to give away our time, but we cannot afford to give away expensive cancer drugs.
If we did, we would be out of business. This weighs heavily on our MD's, RN's and staff. It is getting harder and harder to both emotionally and financially to do our job.
Because the solution to the cancer care crisis is caught up in the health care reform debate, we have no idea how to budget and plan for what may be a drastic shortfall in cash flow in less than 30 business days.
Ultimately, the current Medicare reimbursement cuts and the threat of future cuts will result in a shortage of providers of cancer care and will prevent cancer patients from having access to the latest advances in cancer therapy.
Fixing the broken Medicare payment system is an essential element of comprehensive healthcare reform. We are fortunate to have the best cancer survival statistics and the best access to cancer care in the world.
But Congress must fix the flaws in the Medicare system that will devastate community care of cancer patients.
Dr. Richard Frame is board-certified in Medical Oncology and practices as a physician partner at Utah Cancer Specialists in Salt Lake City.
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