Gainesville, FL – September 12, 2018... Florida Cancer Specialists physician Dr. Lucio Gordan, who also serves as Director, Medical Informatics and Co-Director, Quality CTE, was lead author of the study “The Financial Impact of the Sequester Cut to Medicare Part B Drug Reimbursement in Community Oncology,” which was recently published in theAmerican Journal of Managed Care (AJMC). The study included almost 400,000 Medicare patients who were followed for a 27-month period and were treated in community oncology practices in 33 states.
Results of the study revealed that these community oncology practices have lost $78 million as a result of the ongoing Medicare sequester cut to reimbursement for Part B drugs. This correlates to a loss of more than $847,000 per practice due to the sequester cut. The Community Oncology Alliance (COA) states that these losses have driven an increase in the number of closings and rate of closure of community oncology practices in the United States.
“The sequester cut to Medicare Part B drug reimbursement is both illegal and unconstitutional, and it has cost practices millions of dollars in just the last two years. This is in addition to the billions that it has cost seniors and Medicare in unnecessary spending from shifting cancer care to the more expensive hospital setting,” said Ted Okon, executive director of COA. “The data in this study is eye-opening and should clearly demonstrate the need for Congress and the Trump Administration to fix this misguided constitutional violation.”
Sequestration occurred because Congress was unable to negotiate a balanced budget in 2011. It is an automatic cut to Federal government spending. Beginning in 2013, the Centers for Medicare & Medicaid Services (CMS) starting applying a two percent sequester cut to all Medicare Part B reimbursement, including for chemotherapy drugs.
The study states, “The closure of community oncology practices represents a significant impediment to appropriate access to cancer care. Another negative consequence of the closure of community practices is the shift of site of care from the community setting to outpatient hospital systems.
A September 2017 study, “The Value of Community Oncology: Site of Care Cost Analysis,” which was also
co-authored by Dr. Gordan, found that the total cost of care for cancer patients receiving chemotherapy delivered in the hospital outpatient setting is nearly 60%, or $90,144 per year, more expensive than the same treatment delivered in independent, community oncology practices. Additionally, cancer patients treated in the hospital setting are more likely to visit the emergency department (ED) following treatment, thus, driving healthcare costs even higher.