House Bill To Provide Cancer Patients With Solution For Quality Cancer Care Within An Equitable Medicare Model

Main Category: Medicare / Medicaid / SCHIP
Also Included In: Cancer / Oncology
Article Date: 19 Jun 2009 - 3:00 PDT

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U.S. Representatives Rep. Artur Davis (D-AL), Steve Israel (D-NY) and Mary Jo Kilroy (D-OH) have introduced H.R. 2872, the Medicare Quality Cancer Care Demonstration Act of 2009. H.R. 2872 is a bill that will authorize Congress to direct the Centers for Medicare & Medicaid Services (CMS) to implement the Quality Cancer Care Demonstration (QCCD) project.

The Community Oncology Alliance (COA), a nonprofit group of medical practitioners who deliver cancer care across the country, has been working with the 111th Congress for the QCCD project, described as the "architecture of a solution" to today's cancer care crisis. Health care reform is President Barack Obama's top domestic issue, and when it comes to cancer care, it is overwhelmingly critical.

The QCCD is a multi-phased project that involves medical providers collecting data and implementing a patient-centric program that rewards quality cancer care while controlling costs. The objective of the QCCD is to combine two critical patient enhancing components: treatment planning and end of life care.

"As we address the health care crisis in this country, we can't allow cancer care to fall by the wayside," said Rep. Artur Davis (D-AL). "This bill would expand the availability and quality of care for millions of cancer patients and is a step in the right direction in closing the inequities in the payment system. This bill will help ensure an adequate level of both early treatment and end of life care for patients facing cancer."

This national demonstration project would be implemented in phases by CMS. The QCCD would enable COA to assemble oncologists from practices across the country with advanced electronic medical records for cutting edge data to supplement Medicare claims presented to CMS. This structure would lead to a system that ensures quality cancer care while controlling costs.

The QCCD incorporates the fundamental elements in the healthcare reform debate - quality care delivery, evidence based medicine, care coordination, cost control and health information technology.

The increase in drug costs, combined with the decline in Medicare reimbursements and today's financial crisis, has forced many cancer patients to abandon their treatment. This includes Americans with inadequate or no insurance, as well as seniors who cannot afford to pay the Medicare 20% co-insurance. Approximately 45% of cancer patients are covered by Medicare

"The Quality Cancer Care Demonstration project offers a means of moving forward immediately and the architecture for a solution to the current crisis in cancer care," said Patrick Cobb, M.D., president of COA and managing partner of Hematology-Oncology Centers of the Northern Rockies in Billings, Montana. "All Americans deserve access to quality, affordable health care. And, before we can repair health care in general, we must fix this broken system."

Quality Cancer Care Demonstration (QCCD) Project

Over eight months ago, COA convened a task force of community oncologists and medical policy experts to evaluate the crisis of community oncology and public and private payment systems. The months of evaluation, analysis and brainstorming resulted in the QCCD project, a two-phased Medicare demonstration that will allow Congress to direct the Centers for Medicare & Medicaid Services to implement the program. The project is designed to refine quality metrics and aligns incentives in the critical areas of cancer treatment planning and end-of-life care.

In two phases, the QCCD project first involves testing the metrics and reporting systems, and then involves the program implementation. The objective is to collect data to refine quality metrics and the reimbursement structure into a system that enhances quality cancer care while controlling costs.

COA has constructed a program that CMS can implement through the current coding and data collection systems. COA will augment the collected data from practices that have deployed advanced electronic medical record systems. Additionally, COA will propose the QCCD to private payers in an attempt to launch a national initiative designed to enhance the delivery of quality, affordable, and accessible cancer care to all Americans.

About Community Oncology Alliance (COA)

COA is a non-profit organization dedicated solely to community oncology. COA was founded by community oncology to advocate for patients and providers in the community oncology setting, where 84 percent of Americans with cancer are treated. In only six years of existence, COA has mobilized community oncology to become more politically active, and increased awareness on Capitol Hill about the community cancer care delivery system. Additionally, COA has brought together community oncology practices from across the country to share information in order to enhance the effectiveness and efficiency of the cancer care they provide to their patients. Currently, COA is working with the Congress in providing proactive solutions designed to protect the viability of the nation's cancer care delivery system and patients' access to quality, affordable cancer care.

The cancer death rate in the U.S. has declined due to earlier detection, the quality of treatment, and the accessibility of cancer care. However, according to the American Cancer Society, men still have an approximately one in two lifetime risk of developing cancer, with a risk of one in three for women

Source: Community Oncology Alliance