Preserving Patient Access to Cancer Care

Patient advocates, including the Leukemia and Lymphoma Society, are calling for policy changes that will lower patient out-of-pocket costs, preserve patient access to care with their trusted, community based physician and address trends in healthcare consolidation. Voices across the ideological spectrum are echoing those calls. These are worthwhile goals that support patients, providers and caregivers; it’s time that Congress act to achieve them.

Under current payment policy, Medicare reimburses hospital outpatient medical offices higher rates for the exact same services provided at independent, community cancer clinics. This means patients face increased costs in the form of higher copays. It also puts higher costs onto all taxpayers when Medicare pays more for the same service. For example, chemotherapy administration is reimbursed by Medicare at $333 in the hospital-owned office setting and only $129 in the physician office setting. This means that chemotherapy administration, the most common drug administration code billed by oncology practices, is nearly 3x as expensive if the practice is owned by a hospital. This unfair payment disparity means patients may unknowingly pay higher copays for the same care. It also drives consolidation as hospitals purchase independent, community cancer practices and convert them to hospital owned units. This consolidation means patients might need to travel further for care and will likely pay higher copays for the same treatment they received previously.

Recently, H.R. 4473, the Medicare Patient Access to Cancer Treatment Act was introduced to maintain patient access to community based cancer care centers. It would equalize payments for cancer care services across all sites of service and ensure that cancer patients pay the same amount for the same service regardless of where they receive it. Join with Patients and Providers United to call on Congress to preserve access to community based cancer care providers.