ASCO voiced its strong opposition to the proposed Medicare Part B demonstration project in comments submitted on June 28 for the U.S. Senate Finance Committee hearing, “Examining the Proposed Medicare Part B Drug Demonstration.” ASCO underscored the urgent need to advance a fairer and more responsible payment system for oncology than what is offered in the ill-advised proposal from the Centers for Medicare & Medicaid Services (CMS)—calling on CMS to withdraw the proposal or urging Congress to intervene before this flawed experiment irreparably harms the cancer care delivery system.
“The assumptions and emphasis of the Part B Drug Payment model are misplaced,” said ASCO President Daniel F. Hayes, MD, FASCO, in the statement. “If CMS's goal is to lower drug prices, this demonstration is not designed to achieve that outcome. Rather, the proposed demonstration places doctors and Medicare beneficiaries in the position of making impossible choices without directly addressing the underlying problem of high drug prices.”
Specific Concerns
ASCO's specific concerns regarding the Part B demo include:
Other Considerations
ASCO has also been working on the transition from volume-based to value-based care. The society estimates that its Patient Centered Oncology Payment (PCOP) model, an oncology-specific payment system will decrease costs, while providing the resources oncology practices need to provide high-quality, high-value cancer care, by matching payment more closely with actual care provided. According to ASCO, PCOP will allow practices to plan cancer care in a way that helps patients avoid expensive hospitalizations and unnecessary tests and treatments.
The Part B Model does not take advantage of promising work that has the potential to yield comprehensive reforms and achieve CMS's stated goals. In addition to developing PCOP, ASCO has worked for more than a decade to support oncology practices in the delivery of high-quality, high-value oncology care, through its Clinical Oncology Pathways statement, CancerLinQ, the Quality Oncology Practice Initiative (QOPI), and the ASCO Value Framework.
ASCO believes its work can seed a comprehensive health-care delivery and payment system that will support high-quality, high-value oncology for all individuals facing life-threatening cancers. The society hopes to work closely with CMS and other stakeholders to address the complex issues involved in transforming cancer care in the United States.
“We are hopeful that CMS will realize that this proposal moves payment policy in the wrong direction and is counter to CMS' more constructive efforts,” said Dr. Hayes in the ASCO statement. “However, if they continue to move forward, we urge Congress to intervene to prevent permanent damage to the oncology infrastructure.”
The content in this post has not been reviewed by the American Society of Clinical Oncology, Inc. (ASCO®) and does not necessarily reflect the ideas and opinions of ASCO®.