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What the Medicare Part B prescription pilot doesn’t address

Monday, May 9, 2016   (0 Comments)
Posted by: Kristen Pappaterra
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The May 2 editorial “Drug money,” which endorsed the Obama administration’s proposed Medicare Part B pilot program, did a serious disservice to the patients whose health would be jeopardized by this misguided experiment.

The proposal would bluntly diminish reimbursement rates for medicines covered under Medicare Part B’s otherwise successful payment mechanism. Such a proposal could disrupt patient access by reducing the income of providers, especially those in lower-cost community-based care settings. Many patients receiving medicines under Part B have complex health conditions such as arthritis, cancer and primary immunodeficiency diseases. These patients already face considerable barriers in securing timely and appropriate care.

Driving care into a hospital outpatient setting increases overall health expenditures. For example, Medicare pays $6,500 more and beneficiaries pay $650 more annually for chemotherapy administered in the hospital outpatient setting as opposed to community oncology practices.

If community-based care becomes less financially viable under the demonstration, patients may be required to travel much longer distances to receive care, threatening adherence to treatment and further increasing system costs.

The administration should go back to the drawing board and work with a diverse group of stakeholders to come up with real solutions for improving the program that do not make care less accessible for Medicare’s sickest and most vulnerable patients.

Source. Washington Post. 

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