Published: April 5, 2013
By Renee Elder and Karen Garloch — email@example.com
Cancer clinics in some other parts of North Carolina have reported turning away Medicare patients after cuts beginning April 1 reduced the amount of money available for purchasing expensive cancer drugs.
“Our physicians have decided not to make any changes, although it’s going to force our practice to tighten its belt,” said Tom Grates, executive director of Cancer Centers of North Carolina, a practice with 19 oncologists and six locations in the Triangle. “We are not going to turn any patients away.”
CCNC treats about 1,500 cancer patients each year, more than half of whom are on Medicare, Grates said.
“Cancer chemotherapy drugs are extremely expensive, and for private, office-based cancer centers like ours they become a major cost component,” Grates said. “With the federal government reducing payment by 2 percent, it’s really felt.”
The Medicare program still covers the actual cost of chemotherapy drugs, but has trimmed from 6 percent to 4 percent the additional amount paid to cover costs of storing and administering the drugs.
Changes to Medicare under the sequester affect cancer patients more than others because their drugs must be administered by a physician and are paid for through Medicare Part B, which covers doctor visits and was included in the sequester cuts. Other medications are paid for through Medicare Part D, which also involves private insurance and was not affected by the sequester.
Grates said oncology-specific treatment centers have few options for shifting costs to other areas, unlike hospitals, which have more departments to help absorb the decrease.
Studies have shown that two-thirds of Medicare patients are treated at centers not affiliated with hospitals and that these centers typically charge less for the same treatments.
Oncology programs at Rex Hospital in Raleigh, UNC Medical Center in Chapel Hill, and Carolinas Healthcare System in Charlotte also reported no changes to their cancer programs as a result of the federal budget constraint.
Duke University Medical Center was not able to say whether the sequestration would impact cancer treatment for its Medicare patients.
Turned away in Hickory
Carolina Oncology Specialists, an independent cancer treatment center in Hickory, has already begun turning away some Medicare patients, advising them to continue their treatments at local hospitals, said Linda Travis, practice administrator.
“We are having to look at every patient individually to determine whether or not we will have enough reimbursement to cover cost of drugs,” Travis said. “If it’s very close, if we may lose a few dollars, we go ahead and treat them here. We don’t like having to turn people away.”
Carolina Oncology Specialists has three oncologists on staff and sees about 150 to 200 patients per week – about a third of whom are on Medicare, Travis said. Absorbing all the excess costs without reimbursement would not be financially feasible for the practice, she said.
In Winston-Salem, Wake Forest Baptist Medical Center said it is continuing to treat Medicare patients – at least for the time being.
“We haven’t seen any impact as of now, but that could change in time,” said Dr. Bayard Powell, Wake Forest’s section chief for hematology/oncology.
“We’ve always been in the business of trying to find a way to take care of patients if at all possible.”