In response to the “discussion draft” issued by the Senate Finance and Ways & Means Committees on Medicare payment reform and repeal of the sustainable growth rate (SGR), COA summited comments as requested by the committees. COA strongly believes that the SGR needs to be repealed immediately, because the deeply flawed formula has produced payment cuts that are a “sword of Damocles” hanging over the heads of community oncologists. In addition to the SGR cuts of 24-30% threatening community oncology practices each year, practices are dealing with a damaging sequester cut to cancer drugs and potentially devastating cuts to all aspects of cancer care proposed by the Centers for Medicare & Medicaid Services (CMS).
Overall, COA is pleased with the direction the committees have pursued in shaping payment reform for Medicare. In COA’s comments, it is noted that the committees structured meaningful incentives around the medical home. COA has spent a great deal of time and resources developing the Oncology Medical Home model and has met with the committees over the past year to explain that model and the associated model of payment reform. COA has also been meeting with the Energy & Commerce Committee, and appreciates that committee’s efforts in already passing legislation.
COA’s payment reform model is a 4-phase, 5-year model that is tied to 19 measures of quality and value endorsed by a multi-stakeholder group comprising the COA Oncology Medical Home Steering Committee.
COA will continue to work with all three congressional committees in pressing for repeal of the SGR and meaningful Medicare payment reform based on quality and value in cancer care delivery.
To access COA’s model on Medicare payment reform, which also works for private insurers, click here for a summary schematic.