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Monday, June 17, 2013

Cancer Clinics Turning Away Some Medicare Patients

Cancer patient Lynne Lobel, 47, watches a television program as she gets chemotherapy treatment at Nevada Cancer Institute in Las Vegas, September 2005. (Jae C. Hong/AP)

Cancer patient Lynne Lobel, 47, watches a television program as she gets chemotherapy treatment at Nevada Cancer Institute in Las Vegas, September 2005. (Jae C. Hong/AP)

The federal sequester created a 2 percent across-the-board cut to Medicare, the national health insurance program for Americans age 65 and older.

Among those affected by the cuts are elderly cancer patients who, for a number of reasons including convenience and cost, rely on community cancer clinics instead of hospitals to get their chemotherapy treatment.

“It’s more expensive for Medicare, more expensive for the patient and it’s not local to where they live.”
– Dr. Jeff Vacirca,
on sending clinic
patients to hospitals

Some clinics are now unable to cover the cost of cancer drugs since the government reduced its drug reimbursements as part of the sequester cuts. In some cases, the clinics are turning away Medicare patients, forcing them to go to hospitals.

One of those clinics is North Shore Hematology Oncology Associates in New York, which has decided to turn away one-third of its 16,000 Medicare patients in order to make ends meet.

The clinic’s chief executive, Dr. Jeff Vacirca, says ironically, shifting patients’ care from a clinic to a hospital costs Medicare $7,000 more per year per patient.

“It’s more expensive for Medicare, more expensive for the patient and it’s not local to where they live,” Vacirca told Here & Now’s Robin Young.

And hospitals aren’t happy about it either.

“A lot of the community hospitals are faced with the same sequester cuts we are, and are not interested in getting a high influx of patients,” Vacirca said.

Many elderly cancer patients prefer clinics to hospitals. They’re less expensive, closer to home and doesn’t take a whole day to be treated.

Judy Weiner, 73, has been treated for breast cancer by Dr. Vacirca for the past four years. Her husband has also been treated for metastatic colon cancer for two and a half years.

“The fears that my husband and I have associated with moving over to a hospital for chemo treatment are those associated with infection — there’s a high rate of infection at hospitals,” Weiner told Here & Now. “From a patient perspective, I’m not leaving.”

There is a bill in Congress that would exempt chemotherapy drugs from the 2 percent cut.

“We’re hoping that Congress is going to come to their senses,” said Dr. Vacirca. “You know, we saw them fix the FAA so that we didn’t have to deal with late flights. I find it somewhat ironic that late flights are more important than our nation’s cancer care.”


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  • J Frog

    Does a hospital get reimbursed more for the same services as a clinic?  It sounds that way if everyone is paying more money for services at the hospital.  So where is the Affordable Care Act in all this?  Wasn’t it supposed to streamline costs take absurdities like this out of the system?  Speaking of which:  Time for H&N to do another story on the ACA and the changes soon to be implemented.  Maybe talk about these cryptic Bronze, Silver, Gold, Platinum Plans, expected premiums, copays and maximum out of pocket costs, and savings, if any.  Is anyone going to be able to afford these plans?

    • http://www.facebook.com/people/Nigel-Jessen/100001918780098 Nigel Jessen

      As I understand it, they’ll be an improvement over many current high-deductible “budget” plans that many individuals buy if they’re not covered by an employer. The premiums are likely to be higher in those cases. But then, they may get a tax credit or be covered by expanded Medicaid in many states. Hardly ideal, given that it’s essentially a huge taxpayer subsidy for insurers and providers. But maybe in the end it’ll at least beat millions of people going without decent coverage, and costing everyone else much more when they end up in the hospital. Someone gets to pay.

      An H&N follow-up on some of the details would be a good idea.

  • Pamelaburdick

    Who owns this clinic- the doctors advocating for clinic treatment?

  • Tenncjed

    I like to think that I am not an idiot, but how is a 2% cut resulting in a 33% reduction in the number of patients served?  Am I missing something?  Sounds like they are using this to get rid of patients that aren’t providing enough revenue to make room for others who might be reimbursed at a higher rate.

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Robin Young and Jeremy Hobson host Here & Now, a live two-hour production of NPR and WBUR Boston.

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