Interest fee

Proposed fee reductions will devastate community oncology, says AOC

Many medical groups oppose the cuts to doctors’ 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 an official letter to the CMS, which warns that proposed reductions in the 2023 Physician Fee Schedule will have devastating effects on community oncology practices.

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

“The 2023 physician fee schedule reductions will have a devastating domino effect on our cancer care system, forcing more and more independent practices to cave to the pressures of hospital system amalgamation or even close their doors.” , said Ted Okon, MBA, executive director of COA , in a report

The record of independent practices is already unprecedented. “In just 14 years, more than 1,700 practices have closed, been acquired by hospitals, undergone mergers or reported financial difficulties,” he pointed out. Additionally, “as reimbursement has steadily declined over the past two decades, chemotherapy services provided by independent community oncology practices have declined by 64.3%.”

Besides the ACO, several other physician organizations weighed in on CMS’s draft when it was first published last July.

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

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

The Surgical Care Coalition was more critical of the cuts in a press release it issued at the same time, noting that the CMS is once again “jeopardizing older people’s access to treatment and critical procedures”.

“As surgical care faces another round of proposed cuts, it is clear that these cuts on top of escrow cuts threaten patient care and are not sustainable over the long term,” the surgical care group commented. . “Congress must take action to stop another round of cuts, while 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 practice cost inflation and COVID-related challenges to practicing sustainability, but also includes a large and damaging across-the-board reduction in payout rates,” said WADA President Jack Resneck. Jr, MD, in a statement.

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

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