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Independent News on Advances in Hematology/Oncology CLINICALONCOLOGY.COM • May 2013 • Vol. 8, No. 5
INSIDE
by the
numbers: sequestration
NEW Column How I Manage ... Chronic Myeloid Leukemia ................................ 9
On April 1, the federal government began implementing its sequestration policy, including cuts to Medicare payments.
CURRENT PRACTICE
Previous cancer drug Medicare payments: Average Sales Price + 6%
Vogl, NY...: “Screen, Baby, Screen” ........................ 21
New payment formula: Average Sales Price + 4.3%
The Tumor Board: A large mass at the small bowel mesentery .............................. 24
Percent drop in payments: 28% Community cancer clinics reporting in a survey that they will be forced to change the way Medicare patients are treated as a result: 72%
Maurie Markman, MD: Does ‘X’ cause cancer? .................................... 26 Clinical Conundrums ......................... 27
FORMORE, MORE,see see FOR By the Numbers: Sequestration ............................... 10
“Bubblehead,” a creation of clustered pancreatic adenocarcinoma cells. For more info, see page 8.
EDUCATIONAL REVIEW
The single biggest question facing community oncology today
Guide to Colorectal Cancer Therapeutic Regimens 2013 3 Pocket Guide ...... insert after page 8
Will You Merge or Won’t You? T
here are two kinds of community oncology practices today, says Patrick Cobb, MD, of St. Vincent Frontier Cancer Center in Billings, Mont.: those that have aligned with a hospital or health system, and those that are thinking about it. As of December 2012, Dr. Cobb’s practice is one of the former. “That’s when we officially signed a contract with St. Vincent’s Healthcare to transition us from a private practice clinic to a hospital-based clinic,” Dr. Cobb says. “We couldn’t see any other way that we’d be able to continue to practice given the current economic environment.” Over the last four-and-a-half years, according to an April 2012 Community Oncology Practice Impact report from the Community Oncology Alliance (COA), 241 community oncology clinics have closed altogether; 132 either have merged with or have been acquired by another practice or a corporate entity (like McKesson’s 2010 purchase of US Oncology); and 392 practices either see PRESSURE, E page 11
Four Trends Driving Oncology Practice Consolidation 1. The Medicare Modernization Act of 2003 reducing medication reimbursement rates to the Average Sales Price + 6% 2. Uncertainty raised by “patches” to the Sustainable Growth Rate (SGR) formula for Medicare spending 3. Uncertainty concerning the long-term impact of health care reform 4. An aging oncology workforce
RE VIE WS & COMMENTAR IES
Expert Insights From Mayo Clinic Percutaneous cryoablation eases metastatic bone pain ............................ 14 Scott Okuno, MD
Single-dose radiation effective for cutaneous T-cell lymphoma ............. 17 William Wong, MD