Many U.S. cancer clinics have started to turn away thousands of patients due to the sequester’s cuts to Medicare.
As The Washington Post’s Sarah Kliff reports, some oncologists say the reduced federal funding makes it impossible for community clinics to administer expensive chemotherapy to seniors and remain financially stable. These patients must now seek treatment elsewhere, even as hospitals accepting Medicare beneficiaries grow more overcrowded.
Jeff Vacirca, chief executive of North Shore Hematology Oncology Associates in New York, told Kliff, “If we treated the patients receiving the most expensive drugs, we’d be out of business in six months to a year.” Vacirca said his clinics have stopped administering drugs on which they lose money. His clinics have also ceased to treat one-third of their 16,000 Medicare patients.
Pancreatic cancer patient Harold Rosen, 81, has been receiving chemotherapy at one of Vacirca’s cancer centers, but sequester cuts will soon change that.
“When I first came here, I was afraid to come because everyone’s dying. But everyone here is so pleasant. They smile, they laugh, they care about you. You would never know it’s a place of cancer,” Rosen said to NBC News. Rosen’s physician told him he must start receiving treatment in a hospital.
Vacirca said he is sad to turn away patients like Rosen, but he insists he must.”I have to be financially responsible to be here,” he said. “I owe it to my patients to not go out of business.”
Although Medicare is only facing a 2 percent reduction in funding- much less than other federal programs- oncologists say cancer patients are losing the most.
Seniors’ medications are mostly covered under the optional Medicare Part D. However, cancer drugs must be administered by physicians, and they are paid for by Medicare Part B. Part B covers doctor visits and is facing the sequester’s cuts.
According to Kliff, “The federal government typically pays community oncologists for the average sales price of a chemotherapy drug, plus 6 percent to cover the cost of storing and administering the medication.” But physicians cannot change drug prices, so the 2 percent cut will have to come out of the 6 percent cover charge- “akin to a double-digit pay cut” for clinics.
A recent survey of more than 300 oncology practices by the Community Oncology Alliance determined that 72 percent of them will change how they treat Medicare patients if the cuts continue.
The Alliance has pledged to “fight this unjust and devastating cut to cancer care” with an online petition.
A Milliman report shows that half of all U.S. cancer spending is associated with Medicare beneficiaries. Chemotherapy in hospital settings costs the federal government about $6,500 more than treatment in community clinics does. Some of those costs are then handed to patients, who pay another $650.
Will hospitals be able to absorb these patients? The same study shows almost 70 percent of Medicare patients receiving chemotherapy are treated in community clinics. Clinics in Connecticut, New York and South Carolina have already stopped treating patients.
What is the sequester?
In 2011, Congress passed a law stating that if no legislation was passed to reduce the federal deficit by $4 trillion, some $1 trillion in automatic budget cuts would take effect in 2013.
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