WaPo: Cancer Patients On Medicare Turned Away Due To Budget Cuts

Blaming the sequester budget cuts, clinics are turning away cancer patients on Medicare, The Washington Post reports, because their chemotherapy drugs are too pricey.


(Tips Times/flickr)

The Post’s Sarah Kliff reports:

Cancer clinics across the country have begun turning away thousands of Medicare patients, blaming the sequester budget cuts.

Oncologists say the reduced funding, which took effect for Medicare on April 1, makes it impossible to administer expensive chemotherapy drugs while staying afloat financially.

Patients at these clinics would need to seek treatment elsewhere, such as at hospitals that might not have the capacity to accommodate them.

“If we treated the patients receiving the most expensive drugs, we’d be out of business in six months to a year,” said Jeff Vacirca, chief executive of North Shore Hematology Oncology Associates in New York. “The drugs we’re going to lose money on we’re not going to administer right now.”

After an emergency meeting Tuesday, Vacirca’s clinics decided that they would no longer see one-third of their 16,000 Medicare patients.

“A lot of us are in disbelief that this is happening,” he said. “It’s a choice between seeing these patients and staying in business.”

Have any patients out there experienced this? Tell us your story…

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  • Dennis Byron

    A few minutes of research on this subject gets a little deeper into the story. Too bad journalists jump to conclusions without doing a little Googling. Apparently it’s better to write press articles based on ideology (in this case, opposition by journalists to the cutbacks in 2013-2022 Federal spending growth rates called sequestration).

    The battle between doctors and hospitals over who makes money off chemotherapy has been going on for 10 years as I mentioned in my earlier post. But the proximate cause of this journalistic jingoism against seniors (particularly seniors with cancer) is a survey of “cancer clinics” released March 19, 2013 by the “cancer clinic” lobby.

    The “cancer clinic” lobby must have been disappointed because the survey (http://www.communityoncology.org/UserFiles/Sequestion_CancerCare_Impact_Survey_3-14-13.pdf) said (based on the worst case interpretation of how CMS would interpret a 2% cut, a determination that has not yet been made):

    – 20% of cancer clinics were not doing anything because of sequestration (that is, they were not kicking cancer patients to the curb, nor firing people, nor any of the other dire outcomes claimed in the Kliff piece)

    – 36% of cancer clinics said they would not treat Medicare patients UNLESS the patients had supplemental Medicare insurance (96% of Medicare beneficiaries have supplemental Medicare insurance and certainly all with cancer have it so that means those clinics are doing nothing)

    – 43% of cancer clinics said they would see current Medicare cancer patients but refer them elsewhere for chemo (not clear if they mean current Medicare patients without supplemental insurance or all current Medicare patients)

    – 24% said they would not accept new Medicare patients.

    So, using the most dire scenario (in how CMS cuts the payments) and giving the results the most dire interpretation, less than half of clinics are doing anything like what is claimed by Kliff. In reality, it’s probably more like 70% that are doing nothing one way or the other because of sequestration and 30% are doing something but not kicking patients to the curb. (Kliff must have worked real hard to find a clinic that was doing something and my guess is that that clinic was one of the over thousand the “cancer clinic” lobby claims has been in bad shape since 2008, long before sequestration.) It was possible to answer the survey with more than one choice and 30% said they would do something else also other than kick cancer patients to the curb such as raise prices or lay off nurses or…

    But only 30% of respondents made such an additional observation. That’s why I say the survey seems to say 70% of cancer clinics are doing nothing and 30% are potentially doing something somewhat like but no where near as dire as Kliff claims.

    (And remember this is all part of a bigger 10-year battle over something else.)

  • Dennis Byron

    “…because their chemotherapy drugs are too pricey.”

    That’s not even what Sarah Kliff said, never mind what the real issue is. Kliff pretty much described a real issue correctly; that being the difference in Medicare between Medicare Part B and Medicare Part D drugs. Seniors are more likely to see this difference bubble up in the ways shingles vs. pneumonia vaccinations are handled and in similar more mundane differences between the two needlessly different classes of drugs.

    As for the cancer clinic story, it’s a PR creation. There appears to be a long-standing (back to at least 2003 if not earlier) financial battle between independent doctor practices (these holy “cancer clinics” of which you speak) and hospitals over who makes money on chemotherapy. The battle has nothing to do with sequestration other than sequestration made a good PR technique to sucker journalists into it. According to the “cancer clinic” lobby, hundreds of these clinics have been forced to close since the passage of the MMA in 2003. Obviously that has nothing to do with sequestration. Many of the fraud/waste/abuse cases you read about are related to “cancer clinics.” I don’t know the whole story here but I know it has nothing to do with sequestration