Medicare Sequester Cuts May Jeopardize Cancer Treatment

Doubling Medicare sequester cuts could reduce access to lower-cost cancer treatment.

Increased sequester cuts to Medicare payments may threaten access to cancer care for seniors, according to a press release from the Community Oncology Alliance (COA). The advocacy group is advising legislators that the cuts will primarily affect community oncology providers, but will also affect cancer care around the country.

The COA said that the current 2% sequester cut has already had a negative impact on cancer care and increasing it will be detrimental, especially for elderly patients living in rural areas who may have a limited choice of providers. Additionally, doubling the cuts may increase the deficit, according to the release.

“I have seen firsthand the devastating effect of the blunt axe of the sequester cut on community oncology practices and the patients we serve. Extending it would be a true death blow for many practices struggling to survive against expensive, predatory hospital systems,” said Jeff Vacirca, MD, president of COA and CEO of NY Cancer Specialists in Long Island, NY. “Millions of Americans battling cancer rely on our practices for high quality, affordable, cancer care close to home. I just don’t understand how Congress can threaten this.”

The Congressional Budget Office previously said that pay-as-you-go rules call for a 4% cut to Medicare to prevent deficit increases, according to the COA. This reduction would double the current cuts Medicare has faced due to the 2011 budget deficit, according to the release.

In a 2016 report, the COA found that 91 cancer clinics closed and 130 independent cancer practices merged with larger entities within 5 years of the last sequester. It is likely that if cuts are doubled, the viability of community practices will be further threatened and reduce patient access to cancer treatment, according to the release.

Notably, community oncology practices are where many Americans receive treatment, and closing them may result in consolidation and increase costs for both beneficiaries and taxpayers.

A newer COA report found that the cost of chemotherapy for patients with cancer was nearly 60% more expensive at hospitals than community oncology practices. The difference in treatment location could cost patients up to $90,144 per year for treatment. Losing access to these practices due to sequester cuts may significantly drive up cancer costs, the COA argues.

What has intensified the effect of the 2% sequester cut was the previous administration’s decision to apply the rule to reimbursement for specialty drugs, including those for cancer, according to the release.

The Trump administration has yet to fix this issue that has played a role in increasing costs, the COA said.

“Sequester cuts to Medicare payments are a destructive and shortsighted budget gimmick that hurt cancer patients and ironically fuel the federal deficit,” said Ted Okon, executive director of COA. “It is beyond my comprehension how Congress keeps using the sequester when it has already hurt seniors with cancer. We need Congress and the Trump Administration to undo what is devastating community cancer care.”