Go to the COA website at http://www.communityoncology.org under Immediate Action Needed to access the tool. COA is providing this tool to allow practices to estimate the impact of the proposed rule on 2011 and 2013 billings. There are two scenarios built into the 2011 and 2013 estimates.

The first scenario is that Congress acts to avert the scheduled 23.5% overall Medicare fee cut effective 12/1/10, the 6.1% cut effective 1/1/11, and any subsequent fee cuts through 2013. In this scenario, the model estimates the impact of the oncology-specific fee cuts to infusion room services and the changes to Evaluation & Management codes.

The second scenario is that Congress does not act to avert both the 12/1/10 and 1/1/11 fee cuts.

The tool simply requires you to enter an estimate of utilization by code. Make sure that the numbers you enter are annual (12 months) estimates. The tool is very easy to use.

If you have any questions about the tool, contact Ricky Newton. If you are interested in aggregating your practice data with a national sample in order to benchmark against other practices, email your practice file completed to Ricky Newton. Indicate in your email how many medical oncologists this covers. You will receive back a national report.

Click here to access the current report.

Click here to access the current report.

If this trend continues, the number of closures could double by the end of this year. A recent casualty is the cancer clinic serving Selma, Alabama for nearly 25 years that was forced to shut its doors to patients. In total, 166 clinics have closed over the past three years.

“As a practicing oncologist, I am extremely concerned about the impact these closings have on patients. Many are simply falling through the cracks as providers are being forced to cut staff and close clinics, forcing patients to seek treatments outside of their communities,” said David Eagle, MD, newly elected President of the Community Oncology Alliance (COA).

In the past few years, more than 850 clinics nationwide have experienced severe negative impacts from annual cuts to cancer care by Medicare. This number includes clinics that have closed their doors; continue struggling financially to pay bills to operate; are forced to send all of their Medicare patients elsewhere for treatment; or have been acquired by hospitals or other entities.

As a result, a growing number of cancer patients are unable to receive care in their communities, and many cannot travel the distances required to get treatment. Rural practices and those with higher proportions of Medicare and Medicaid patients are particularly hard hit. Four out of five U.S. cancer patients are treated in the community setting, and approximately half of all U.S. cancer patients are Medicare patients. (2)(3)

“Delays in resolving major Medicare cuts to all physicians have compounded the very serious problems already facing community oncology practices due to continued payment cuts to cancer care,” said Ted Okon, Executive Director of COA. “We are seeing community oncology offices cutting staff, services, and ultimately closing at a much faster pace since the beginning of 2010. The economic reality is that practices cannot continue to operate when their costs are greater than revenues. This country has the best, most efficient cancer care delivery system in the world, yet unrealistic payment policies are pushing it off a cliff. This is nothing less than a national crisis.”

Compounding the problem, the nation is losing oncologists relative to the mandate for cancer care.(4) By 2020, there will be a shortage of 4,080 oncologists, causing cancer patient demand to outstrip the supply.(5) It is estimated that by 2020, one in four cancer patients will be short an oncologist.

Additionally, as oncologists retire, fewer physicians are choosing to treat cancer. National Analysts reported that one in five (20%) oncologists would discourage a medical student/resident from pursuing a career in oncology, versus only 3% who would have done so in 2003, prior to the problems caused by year-over-year Medicare cuts.(6) The cancer mortality rate in the U.S. has declined due to earlier detection, the quality of treatment, and the accessibility of cancer care. The American Cancer Society’s just-released Cancer Statistics 2010 estimates that 767,000 U.S. lives were saved from 1990-2006 by reducing the cancer death rate.(7) Yet, cancer is still the number one killer of Americans under age 85.

“The government has to act now to stop Medicare cuts in order to preserve our nation’s cancer care delivery system before it’s too late,” said Okon.

(1) Based on the Community Oncology Alliance cancer impact database compiled from data from private and public sources. (2007 – current)
(2) NCI Community Cancer Centers Program (NCCCP). Pilot Program Summary. 2007
(3) Avalere Health. Providing High Quality Care in Community Oncology Practices: An Assessment of Infusion Services and Their Associated Costs. February 2010
(4) Erikson et al, “Future Supply and Demand for Oncologists: Challenges to Assuring Access to Oncology Services” Journal of Oncology Practice. 2007 2:79-86
(5) Ibid.
(6) National Analysts Worldwide. Oncologists Look at Oncology: The Prognosis for US Cancer Care. September 2008
(7) Jemal, et al. “Cancer Statistics, 2010,” CA: A Cancer Journal for Clinicians: 2010:60(5)

Read more: http://www.politico.com/news/stories/0710/39752.html#ixzz0tlDGtiCi

I highly encourage you to read Dr. Eagle’s insightful letter to all in community oncology. Click here to read Dr. Eagle’s letter.

Dr. Eagle is joined by Dr. Robert Hermann from Georgia, who has been elected to serve as Vice President of COA and Dr. Mark Thompson from Ohio, who was elected to the position of Secretary. Both Dr. Hermann and Dr. Thompson have been very involved with COA since its inception and join a very talented Executive Committee team.  Rounding out this team are the following individuals:

• Ricky Newton, CPA, Treasurer (Virginia)
• Patrick Cobb, MD, Immediate Past President (Montana)
• Harry “Mac” Barnes, MD, Past President (Alabama)
• Scott Tetreault, MD, Officer at Large (Florida)

The Executive Committee reports to the COA Board of Directors, which is comprised of a dedicated group that includes oncologists and administrators from community oncology practices across the country. When you read Dr. Eagle’s letter, look at the diversity and talent of the COA Board. The Board meets via call every three weeks on Monday night and at least twice during the year in person. The dedication of these individuals is amazing and a real show of unity in community oncology. Unifying the grassroots of community oncology is essential for it to survive and prosper under the changes coming from health care reform.

Finally, I would like to thank Dr. Patrick Cobb for his service as the President of COA. Few realize or appreciate all of the time that Dr. Cobb has spent on Capitol Hill advocating for the interests of community oncology practices. Traveling from Montana to Washington, DC is not easy and Dr. Cobb has tirelessly made the trip more times than I can count during the health care reform debate. Fortunately, Dr. Cobb will continue to be very involved with COA and legislative activities. The COA Board has formalized a new COA Policy Committee and Dr. Cobb will assume the chair of that body. Please join me in thanking Dr. Cobb.

CMS now requests stakeholder review and public comment on the measure. Comments must be received by Friday, July 30, 2010. To be considered, comments must be forwarded to Quality Insights of Pennsylvania via email at measures@wvmi.org on the internet.  Please include your name, credentials, and email address in your message, and indicate whether you are commenting as an individual or as a representative on behalf of an organization.

To review the measure in more detail, please visit CMS’ Measures Management System online at: https://www.cms.gov/MMS/17_CallforPublicComment.asp on the CMS website.
A summary of all the comments received will be posted on CMS’ Measures Management System website about four weeks after the public comment period closes.