How Are Your Peers Coping With Medicare? COA Reports

Nearly 50% of practices submitting data to the Community Oncology Alliance (COA) reported sending at least 6 patients per week to a hospital for chemotherapy due to changes in Medicare reimbursement. This is one of several findings from data that COA has collected since February 2006.

COA posted a short survey on its website about 5 months ago and invited members to complete it weekly to document the impact of Medicare reimbursement policies on access to cancer care. A total of 139 practices in 37 states submitted responses at some point during the 5 months or so that data collection has occurred. Findings as of June 30 appear on the COA website and include the following:

• About 45% (62) of practices submitting data reported experience delays in scheduling patients for chemotherapy at other facilities.
• About 62% (86) of practices reported pre-certifying Part D medication; the others do not.
• About 37% (51) of practices reported patients being denied medication through Medicare Part D. Another 23% (32/139) are unsure; the rest report no denials.
• Most (86%; 119/139) practices have hospitals in their communities to which they can refer Medicare patients for chemotherapy. Practices in rural areas commonly do not have hospitals to which they can refer patients.
• Virtually all practices reporting to COA still accept Medicare patients (137/139). About 16% (23/139) do not accept Medicare patients without secondary or Medigap insurance.