Thursday, June 17, 2010

Medicare cuts increase cancer treatments, study finds

In healthcare, less money doesn't always mean less service.

The 2005 Medicare Modernization Act, which substantially reduced Medicare payments to physicians for administering outpatient chemotherapy drugs, has had a somewhat paradoxical effect. Rather than resulting in fewer treatments, as one might expect, a new study finds that the Act has actually increased chemotherapy treatment rates among Medicare recipients.

"This sort of dynamic runs contrary to what most people would expect, but economists often encounter this sort of thing," says Joseph Newhouse, the John D. MacArthur Professor of Health Policy and Management at Harvard University and faculty member at Harvard Medical School, Harvard Kennedy School, Harvard School of Public Health, and the Faculty of Arts and Sciences, who carried out the study with colleagues Mireille Jacobson, now at RAND, Craig Earle, now at Sunnyside Medical Center, and Mary Price.

The study will be released on June 17 as a web first by Health Affairs, and will also appear in its July edition.

Unlike the process for prescribing and billing for typical drugs, in which physicians simply write prescriptions that patients must then fill, oncologists purchase chemotherapy agents directly from pharmaceutical companies and then bill the patient's insurer. But they don't necessarily bill for what they paid.

Like cars, these drugs have a "sticker price," that is, a manufacturer's suggested cost that may or may not reflect what doctors actually pay. Many doctors will often purchase the drugs at a price far below the suggested cost and then bill insurance for the suggested price, making upwards of a twenty percent profit.


Source and More:
http://www.physorg.com/news195971874.html

Medicare Rules and Regulations: A Survival Guide to Policies, Procedures and Payment Reform/1995-96The Veteran's Survival Guide: How to File and Collect on VA ClaimsThe Medicare Recovery Audit Contractor Program: A Survival Guide for Healthcare Providers

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