Thoughts From COA

CMS/CMMI Releases Oncology Payment Reform Model

Created on: Thursday, February 12, 2015

CMS/CMMI has released its model for oncology payment reform. The model is along the lines of the COA Oncology Medical Home model with a care management fee and then a performance-based fee with quality measures. We have some initial questions and concerns about details, including the actual launch of the program. However, COA appreciates the openness of CMMI to feedback that COA and others have been providing. We will have more details after our task force of oncologists and practice administrators analyze the CMMI model with the details provided by the innovation center.

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2015 Community Oncology Conference Open for Registration

Created on: Tuesday, January 13, 2015

We expect the 2015 Community Oncology Conference to be bigger than the 2014 version, which was a huge success. By popular demand, we are going back to Orlando. The highlight of the 2015 Conference will be sessions on oncology payment reform, picking up where the successful Payer Exchange Summit on Oncology Payment Reform left off from the fall of 2014. The 2015 Conference will have workshops dedicated to key aspects of oncology payment reform and you’ll learn more about private pay and Medicare programs, in the field and proposed.

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Top Ranking House Member McMorris Rogers Releases Draft Bill on Oncology Payment Reform

Created on: Thursday, December 11, 2014

Congresswoman Cathy McMorris Rogers (R-WA) has released a discussion draft of a bill on oncology payment reform she intends to introduce when the new Congress convenes in 2015. The legislation will establish a national oncology medical home demonstration project under the Medicare program to reform the payment system for cancer care in order to enhance the quality of care and to improve cost efficiency. The 5-year nationwide demonstration project will be open to oncology practices billing under Medicare Part B, including both independent and hospital-affiliated community cancer clinics, and is comprised of three phases.

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CMS Releases MD and Hospital Fee Schedules for 2015

Created on: Saturday, November 01, 2014

The final fee schedules for both physicians and hospitals for Medicare in 2015 have been released by CMS. Medical oncology and hematology will receive a 1% payment increase in 2015. Radiation therapy will receive no increased payment next year; however, CMS had proposed an 8% reimbursement decrease. Radiology will be cut by 1%; however, the proposal was to cut radiology services by 4%. COA sent CMS a comment letter that addressed the cuts to radiation and imaging, and worked with key congressional offices in signing letters and weighing in against the proposed cuts. You can access the final physician rule...

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60 Minutes Acknowledges COA Blasted It for Reporting Inaccuracies in Cancer Drug Costs Show

Created on: Monday, October 06, 2014

As we posted last week, COA was contacted by 60 Minutes earlier in the year about a segment on cancer drug pricing. Several of the COA leadership told the accurate story on camera, as well as provided 60 Minutes with data supporting the quality and cost efficiency of community oncology providers. Unfortunately, 60 Minutes ignored the facts in order to fit what seems to be a pre-determined conclusion within their story on cancer drug pricing. COA blasted 60 Minutes in a letter from President Bruce Gould, MD about the inaccuracies and the adverse impact false information can have on cancer patients. Reporter Lesley Stahl acknowledged the letter on air on 60 Minutes.

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COA Submits Comments to CMS on Proposed 2015 Medicare Physician Fee Schedule

Created on: Tuesday, September 02, 2014

COA President Dr. Bruce Gould submitted comments to CMS on the proposed fee schedule for physicians for 2015. In the letter, Dr. Gould states, "If you look at what is happening in community oncology with payment reform there is much hope going forward, as community oncology is collectively well ahead of academic and institutional-based oncology, as well as other areas of medicine, in implementing payment reform. However, the advances being made are threatened by the continued ratcheting down of Medicare reimbursement for cancer care by CMS, as well as by Congress’ inability...

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Estimate the Impact of the 2015 Proposed Medicare Fee Schedule

Created on: Wednesday, July 30, 2014

COA has released its updated model that allows community oncology practices to estimate the financial impact of the proposed 2015 Medicare Physician Fee Schedule. The model estimates the impact of infusion services and E&M reimbursement changes, as well as those impacting practices with imaging and radiation therapy. You can download a copy of the Excel-based model and can contact Bo Gamble with any problems or questions. CMS is accepting comments on the proposed Medicare Physician Fee Schedule until close of business on September 4, 2014.

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COA Board Approves Position Statement on 340B

Created on: Wednesday, July 23, 2014

The COA Board of Directors developed and released a position statement on the 340B drug discount program. COA Executive Director Ted Okon stated that, “This position on the 340B program took a lot of thoughtful deliberation by the COA Board. The program is a critical safety net for patients in need but it requires modification because it is unsustainable. When the bubble bursts it will be those very patients in need who will be adversely impacted. We hope that all providers and organizations come together proactively to engage in constructive dialogue about strengthening the program to ensure that every...

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CMS Releases Medicare Physician Fee Schedule and Outpatient Proposed Rules

Created on: Sunday, July 06, 2014

CMS released the 2015 Medicare Physician Fee Schedule proposed rule on July 3, 2014 with the proposed rule for outpatient hospital departments. CMS will accept comments on the rules until the end of day on September 2, 2014. COA will have a thorough analysis on the physician rule's impact on community oncology practices. For now, an overview of that rule shows a 1% fee increase for medical oncology, a 2% fee cut to imaging, and a 4% fee cut to radiation therapy. There are other provisions in the rule affecting community oncology. To access a copy of the rule and a fact sheet...

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New COA-Sponsored Study Reveals Shift to 340B Hospitals Increases Costs of Cancer Treatment

Created on: Tuesday, June 10, 2014

The Berkeley Research Group (BRG) released a new study finding that two independent trends, acting in combination, are currently resulting in increased Medicare fee-for-service (FFS) chemotherapy payments. These results reinforce similar findings in previous studies by Avalere Health, Milliman, and The Moran Company. The first trend is a shift in the site of care for cancer patients from physician-owned community cancer clinics to hospital outpatient departments. The second trend is the expansion of the delivery of oncology services by 340B hospitals in recent years through the acquisition of community cancer practices (typically comprising multiple treatment clinic sites).

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