GOVERNMENTDrug pay cut could disrupt cancer careA projected 15% average reduction in Medicare cancer drug reimbursement rates next year is a larger drop than doctors expected.By David Glendinning, amednews staff. Oct. 18, 2004. Washington -- Therese Mulvey, MD, worries that she'll have to make tough choices about how her patients will get their cancer therapy. Absent congressional action before year's end to shore up Medicare payments for some of the most widely prescribed outpatient cancer drugs, Dr. Mulvey's large oncology practice in Dorchester and Quincy, Mass., could begin shifting some patients to local hospitals for treatment, she predicted. Dr. Mulvey isn't the only one facing hard decisions. Changes starting next year in Medicare reimbursement for drugs administered in doctors' offices might make it financially unfeasible for oncologists nationwide to continue providing chemotherapy in that setting, said the American Society of Clinical Oncology. A major shift in cancer care from the office, where 80% of cancer patients receive treatment, to the hospital could be in the making. Physicians considering such a move worry about an accompanying host of patient-safety and quality-of-care issues, Dr. Mulvey said. "A lot of the safety checks when you administer chemotherapy are done by the nurses," she explained. "If the nurses are not accustomed to the drugs and cannot anticipate side effects before they occur, or don't know what side effects to even look for, that concerns me." Medicare beneficiaries who must begin forgoing the clinic setting for their care might seek treatment at hospitals that are overwhelmed by the influx of unfamiliar types of patients, she predicted. These facilities' inexperience with cancer cases could lead to delays in care and added administrative burdens for everyone involved. [...]Full text of American Medical News content is available to AMA members and paid subscribers.
Copyright 2004 American Medical Association. All rights reserved.
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