Is health care reform dead? No.

COA President Dr. Patrick Cobb and Executive Director Ted Okon have just penned an article on this for OncologySTAT. You can access it on the COA website at http://www.communityoncology.org under COA Media Center. The article looks at the fallout from the recent Senate election in Massachusetts and options being weighed by the Democratic leadership.

At the time of this email, there is serious consideration being given to the option of passing the Senate health care reform bill in the House, which would result in an immediate bill that President Obama could sign. Objections to the Senate bill would be handled in separate legislation passed under budget reconciliation, which only requires 51 Senate votes. This may sound like a stretch, but it is being worked very hard behind the scenes. Votes are being counted to see if this tact is possible, especially in light of the election results.

Regardless of the outcome of this attempt to save the current legislation crafted by the Congress, health care reform will happen. It may be that we will see a series of smaller bills that can gain bipartisan support. The bottom line, putting all politics aside, is that there is almost universal agreement that we need to reform health care.

Even without any legislation, the Centers for Medicare & Medicaid Services (CMS) is moving on its own to curb Medicare spending and reallocate resources. Look at the cuts to oncology, cardiology, imaging, and consultations. Especially if a comprehensive bill is not passed, CMS will move to more aggressively curb Medicare spending. The agency has already been mandated to pursue value-based pricing. Bundling payments, as they have done in dialysis, will extend to other areas of medicine.

So, no, heath care reform is not dead. It is here to stay.

Quick update on the 21.2% Medicare payment cut looming on March 1st…

We have heard widespread comments from members of Congress that the intention is to address the reimbursement cut before the March 1st deadline. It appears very unlikely that Congress has the ability to actually fix the Sustainable Growth Rate (SRG) at this time, given the price tag of over $200 billion. It appears that a patch, from 2 to 5 years, is the likely solution. Everything is in flux; however, odds favor a 2-year patch (or at least 18 months to get past this election year). A 5-year patch would be more likely if the Democratic leadership pulled a rabbit out of its hat and could pass the Senate bill in the House. That is because when the patch runs out the independent Medicare spending commission created by the Senate bill would be empowered. They would be mandated to simply cut Medicare spending by allowing the physician fee schedule cut at that time to take effect, with little that Congress could do. However, understand that nothing is close to certain at this time and the 21.2% payment cut looms until Congress acts to avert it.