Community Oncology Alliance Gathers In Washington To Address Crisis In Access To Cancer Care

The Board and Officers of The Community Oncology Alliance — representing cancer clinics caring for over 85% of the USA’s cancer patients — will gather with hundreds of oncologists, nurses, and allied health professionals in Washington, DC for the First Annual Community Oncology Conference at the Marriott Wardman Park Hotel February 8- 10, 2006. The three day conference will focus on the crisis in cancer care caused by the Medicare Modernization Act (MMA) which sought to modernize reimbursement for cancer drugs and essential cancer care services by reforming the payment systems for oncology.

“The reform was woefully short,” states Steve Coplon, Co-Executive Director of COA. “The Medicare Modernization Act overcorrected drug reimbursement to below cost and under corrected service reimbursement to below cost. Essentially, cancer clinics are now subsidizing cancer care for Medicare patients. A typical example occurred yesterday,” Coplon adds. “Our clinic is currently treating a patient with Non-Hodgkin’s Lymphoma. Current reimbursement for that care is $1,607 below our cost. The patient’s co-insurance is over $3,000. If the patient can’t afford the co-insurance, we will subsidize the treatment though the clinic will be reimbursed $4,600 below cost. In either case clinics cannot afford to subsidize this care.”

Similar situations are being reported by cancer clinics throughout the country, and as a result many patients are being shifted to hospital in-patient and/or outpatient settings which can result in more cost to Medicare, unnecessary treatment delays, long waits, and lower quality care. In some communities hospitals are not accepting these patients because cost greatly exceeds reimbursement. A number of oncology groups are further reporting that they can no longer treat Medicare patients — including a group in New Orleans, one group in Iowa, and another in Panama City, Florida. Many other similar reports have emerged from dozens of states.

“MMA was supposed to fix a broken payment system for oncology,” said Leonard Kalman, MD, a Miami based oncologist and President of COA. “Instead oncology reimbursement has been cut by $15.7 billion over 10 years — adversely impacting quality and access to care. This overcorrection needs to be fixed before the crisis gets out of hand any further.”

Representatives from COA are encouraged that their message is being heard in Washington. “COA has a voice at the table,” affirms Chief Administrative Officer, Dianne Kube. “We regularly meet with Congressional leadership, The White House, CMS, MedPAC, and other agencies addressing reimbursement for cancer care. In addition, we have legislation, HR 4098 — The Community Cancer Care Preservation Act, introduced by Congressman Jim Ramstad, Republican of Minnesota. This legislation addresses many of the deficiencies of MMA. Unfortunately, policy issues do not move as quickly as we would like.”

“For cancer clinics like ours in Memphis this means that patients are experiencing a regression in ‘The War on Cancer,’” declares Coplon. “Oncologists, nurses, and patients from around the country are deeply concerned that much of the progress in early diagnosis and treatment and much of the cost savings resulting from care in the office setting is now going to be lost as care shifts to hospitals or does not occur at all. Some patients have indicated that they will not go to the hospital for care. The real tragedy is that we have come so far in this fight and now MMA is forcing us to retreat rather than advance.”

The three day gathering in Washington will lay out strategies for policy change before the crisis exacerbates.

For additional information contact Dianne Kube, Community Oncology Alliance, 202-756-2258.

The Community Oncology Alliance (COA) is committed to fostering and protecting high quality, affordable and accessible cancer care for all Americans battling cancer. COA’s vision is to strongly promote initiatives that further enhance the quality and affordability of cancer care, which along with accessibility have been hallmarks of cancer treatment delivered in the community setting where over 80% of Americans with cancer are treated.

Community Oncology Alliance
www.communityoncology.org