Proposed Fee Cuts Will Devastate Community Oncology, Says COA

Roxanne Nelson, RN, BSN

September 08, 2022

Many medical groups are opposing the cuts to physician fees proposed by the Centers for Medicare & Medicaid Services (CMS), with each group setting out its specific arguments.

Among them, the Community Oncology Alliance has submitted a formal letter to the CMS, which warns that the cuts proposed in the 2023 Physician Fee Schedule will have devastating effects on community oncology practices.  

The COA warns that clinicians would face a 5.6% cut in total reimbursement. This cut consists of an 8.6% reduction for infusion services, a 5.4% decrease for imaging services, and a 3.9% decrease for evaluation and management (E&M) services.

"The 2023 Physician Fee Schedule cuts will have a devastating domino effect on our cancer care system, causing more and more independent practices to give in to hospital system merger pressures or even close their doors," said Ted Okon, MBA, executive director of COA, in a statement

The toll on independent practices has already been unprecedented. "In just 14 years, more than 1700 practices have closed, been acquired by hospitals, undergone mergers, or reported financial struggles," he pointed out. In addition, "as reimbursement has been continually ratcheted down over the last two decades, the chemotherapy services delivered by independent community oncology practices declined by 64.3%."

Aside from the COA, several other physician organizations weighed in on the CMS draft when it was first released this past July. 

While the American Society of Clinical Oncology (ASCO) continues to analyze the full proposal, they noted in a press release that CMS estimates a negative 1% overall impact for the hematology/oncology specialty and a negative 1% overall impact for the radiation oncology specialty in 2023.

These estimates also do not factor in the 3% reduction in the conversion factor, but the actual impact on individual clinicians will vary based on geographic location and the mix of Medicare services billed, ASCO notes.

The Surgical Care Coalition was more critical of the cuts in a press release they issued at the same time, noting that once again, CMS "jeopardizes seniors' access to critical treatments and procedures."

"As surgical care faces another round of proposed cuts, it's clear that these cuts on top of the sequester cuts threaten patient care and are unsustainable for the long term," the surgical care group commented. "Congress must take action to stop another round of cuts, while also stabilizing the system, to protect patients and the care they need."

The American Medical Association (AMA) also expressed immediate objections to certain aspects of the proposal.

"It is immediately apparent that the rule not only fails to account for inflation in practice costs and COVID-related challenges to practice sustainability, but also includes a significant and damaging across-the-board reduction in payment rates," said AMA President Jack Resneck Jr, MD, in a statement.

Roxanne Nelson is a registered nurse and an award-winning medical writer who has written for many major news outlets and is a regular contributor to Medscape.

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