WASHINGTON, Feb. 23, 2018 /PRNewswire-USNewswire/ --
Hospitals in Massachusetts,
especially those in rural areas, will benefit from recent changes
to Medicare payments, including changes to reimbursement of
prescription drugs under a federal program known as the
340B Drug Pricing Program.
On average, Massachusetts
hospitals will see a 2.5 percent increase—or an additional
$52,896,645—in Medicare payments
related to the changes.
These findings are included in new research released by Avalere
Health, a nonpartisan DC-based firm that analyzes the impact of
health policies. The study dispels misinformation being touted by
some large, corporate hospitals that the Medicare changes to the
payment of drugs purchased under the 340B program would bring drastic cuts to hospital
reimbursement and threaten their operations. Massachusetts hospitals are estimated to
receive nearly $2.2 billion in net
Medicare payments as a result of the changes in 2018.
Started by Congress in 1992, the 340B program gives certain hospitals and clinics
that treat high numbers of uninsured or underinsured patients steep
discounts on drugs purchased. The program has grown substantially,
morphing into a profit-generating program for most hospitals who
can make upwards of 50 percent profits selling drugs purchased at a
discount to insured patients. Today, nearly half of all acute care
hospitals participate in the 340B
program. Recognizing that it is being abused by some hospitals, the
government sought to reduce the profit motivation by adjusting the
payment rate for drugs purchased through 340B beginning this year.
"Contrary to what the public and Congress is being told, the
vast majority of America's hospitals, and in particular rural
hospitals, are benefitting from recent Medicare's payment changes,"
said Ted Okon, executive director of
the Community Oncology Alliance (COA) which commissioned the study.
"All Massachusetts hospitals benefit from the recent 340B and
Medicare changes, not just a select few. What's more, consumers
will save money in lower drug co-pays, so everyone wins."
Experts from the Centers for Medicare & Medicaid Services
(CMS) predict that the changes to 340B payments will save seniors an estimated
$320 million in drug copayments
nationally in 2018 alone.
Many 340B hospitals have predicted
that reductions in program reimbursement, which took effect on
Jan. 1, would cause them to lose
revenue. The Avalere research shows that increases in Medicare Part
B payments for non-drug items and services have more than offset
the 340B cuts, with 42 states,
including Massachusetts, seeing
overall payment increases.
"Community oncology clinics care about the 340B program because some hospitals abuse is as a
business strategy to take over local cancer care and make money,
not help patients. It's time hospitals started using 340B to help patients the way the program was
intended, instead of irreparably harming the backbone of our cancer
care system. When local clinics shut down, patients suffer," said
Steven L. D'Amato, executive
director of New England Cancer Specialists and a member of the COA
board. "The Avalere data are clear: Massachusetts hospitals aren't going to lose
money from the recent Medicare payment changes and 340B reforms, like some claim. They should be
championing these changes, not fighting them."
According to the most recent Community Oncology Alliance
Practice Impact Report, Massachusetts has seen 14 community oncology
clinics close or merge into the hospital setting since 2008. This
results in less choice in local cancer care providers and
significantly higher costs to patients for the exact same cancer
care.
The Avalere analysis comes on the heels of an independent study
released last week in the New England Journal of Medicine (NEJM)
which found that the 340B program
driving consolidation of the nation's cancer care system into the
much more expensive hospital system; is associated with hospitals
administering more cancer drugs; and has not resulted in any clear
expansion care or lower mortality for needy patients.
The Avalere study and methodology are available at
https://www.communityoncology.org/20180126_opps-analysis-final/.
About the Community Oncology Alliance: COA
is a non-profit organization dedicated to advocating for community
oncology practices and, most importantly, the patients they serve.
COA is the only organization dedicated solely to independent
community oncology where the majority of Americans with cancer are
treated. The mission of COA is to ensure that cancer patients
receive quality, affordable, and accessible cancer care in their
own communities. For more than 15 years, COA has built a national
grassroots network of community oncology practices to advocate for
public policies that benefit cancer patients. To learn more about
COA, visit www.CommunityOncology.org. Follow COA
on Twitter at www.twitter.com/oncologyCOA.
Follow COA on Facebook
at www.facebook.com/CommunityOncologyAlliance.
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SOURCE Community Oncology Alliance