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Health-Care Policy

Studies Show the U.S. Health-Care System Hampered by Waste and Trailing Other High-Income Countries

Recent studies show that at least one-quarter of our nation’s health-care expenditures are being consumed by waste, fraud, and abuse. Moreover, since 2004, annual reports from the Commonwealth Fund have consistently rated the performance of our health-care system last among high-income countries,...

Issues in Oncology
Cost of Care
Health-Care Policy

New Policy Brief Explains How Co-pay Accumulators, Maximizers Increase Cost of Cancer Care for Patients

Health insurers, employers, and pharmacy benefit managers (PBMs) have shifted a growing share of the costs for specialty prescription medicines to their patients and beneficiaries. Since insurer cost-sharing requirements for prescription medications can be uniquely burdensome compared to other...

Health-Care Policy
Palliative Care

Palliative Care Bill Unanimously Approved by U.S. House of Representatives

On October 28, the U.S. House of Representatives unanimously approved the Palliative Care and Hospice Education and Training Act (PCHETA). The bipartisan bill would increase federal research funding for palliative care—including pain and symptom management—and would establish palliative care...

issues in oncology
health-care policy

Justin Barnes, MS, on the Affordable Care Act and Risk of Suicide in Patients With Cancer

Justin Barnes, MS, of the St. Louis University School of Medicine, discusses his findings on the risk of suicide, which is higher in patients with cancer than in other adults but can be reduced by health policy interventions, including components of the Affordable Care Act (Abstract LBA9).

Issues in Oncology
Health-Care Policy
Legislation

AACR Cancer Progress Report 2019 Released

Today, the American Association for Cancer Research (AACR) released the AACR Cancer Progress Report 2019, which highlights how research largely supported by federal investments in the National Institutes of Health (NIH) is spurring improvements in public health and innovations across the spectrum...

Issues in Oncology
Gynecologic Cancers
Health-Care Policy

ASTRO 2019: Effect of Closure of Women’s Health Clinics From 2010 to 2013 on Cervical Cancer Screening and Detection

Following the closure of nearly 100 women’s health clinics across the United States from 2010 to 2013, fewer women were screened for cervical cancer; more women were diagnosed with advanced stages of the disease; and disease mortality rates rose. Findings from a new analysis combining several...

Health-Care Policy

2020 Fee Schedule Proposal Outlines E&M Code and MIPS Changes

On July 29, the Centers for Medicare & Medicaid Services (CMS) released its proposed rule for the 2020 Medicare Physician Fee Schedule (MPFS) and other changes to Medicare Part B payment policies, including proposals related to the Quality Payment Program (QPP). At the same time, CMS released...

issues in oncology
health-care policy

Karen M. Winkfield, MD, PhD, on Policy and Business Solutions to Address Disparities in Cancer Care

Karen M. Winkfield, MD, PhD, of the Wake Forest Baptist Medical Center, discusses cultural factors that contribute to cancer care disparities, the role of national policy in addressing inequities in access to care, and what local institutions can do to improve the situation.

Health-Care Policy
Immunotherapy

CMS Finalizes Decision to Cover CAR T-Cell Therapy for Medicare Beneficiaries

ON AUGUST 7, the Centers for Medicare & Medicaid Services (CMS) finalized the decision to cover U.S. Food and Drug Administration (FDA)-approved chimeric antigen receptor (CAR) T-cell therapy among recipients of Medicare benefits. FDA-approved CAR T-cell therapies are approved to treat patients ...

health-care policy
immunotherapy

CMS Finalizes Decision to Cover CAR T-Cell Therapy for Medicare Beneficiaries

On August 7, the Centers for Medicare & Medicaid Services (CMS) finalized the decision to cover U.S. Food and Drug Administration (FDA)-approved chimeric antigen receptor (CAR) T-cell therapy among recipients of Medicare benefits. FDA-approved CAR T-cell therapies are approved to...

Issues in Oncology
Health-Care Policy

Looking at the Impact of State Policies on Access to High-Quality Care

The state of Washington is adding a public option to its health insurance marketplace; Massachusetts, Connecticut, and others have passed laws requiring that payers cover fertility preservation procedures for patients with cancer. Many states are seeking to expand Medicaid eligibility, and some, in ...

Issues in Oncology
Health-Care Policy

The Unhealthy Health-Care System, and How to Fix It

BOOKMARK Title: An American Sickness: How Healthcare Became Big Business and How You Can Take It BackAuthor: Elisabeth Rosenthal, MDPublisher: Penguin PressPublication Date: April 2017Price: $27.95, hardcover; 416 pages The United States spends considerably more on health care than all other...

health-care policy
issues in oncology

Leading Organizations Call on Congress to Help Eliminate HPV-Related Cancers

Today, the American Association for Cancer Research, Moffitt Cancer Center, and Biden Cancer Initiative hosted a congressional briefing titled “Let’s End HPV-Related Cancers” in Washington, DC. In conjunction with this briefing, leading health organizations and...

breast cancer
colorectal cancer
health-care policy
issues in oncology

Medicaid Expansion and Colorectal Cancer Screening

A new study examining Medicaid expansion and cancer screening found that the five states and District of Columbia that first adopted Medicaid expansion saw larger increases in colorectal cancer screening than states that did not expand Medicaid. The study—published by Fedewa et al in...

Issues in Oncology
Health-Care Policy

Major Settlement Raises Questions About Evidence-Based Value in Cancer Care

An Oklahoma jury recently awarded $25.5 million to the widower of a 53-year-old woman diagnosed with stage IV nasopharyngeal cancer who was denied coverage for proton therapy by her health insurer, Aetna. The patient’s family subsequently raised $92,000 to cover her proton therapy at The University ...

Issues in Oncology
Health-Care Policy

ACA Increases Access to Health Care, Early Diagnosis, and Timely Treatment for Patients With Cancer

  The evidence is in: the Affordable Care Act (ACA) has enabled improved access to earlier diagnosis, earlier care, and reduced racial disparities in access to care for patients with cancer, according to two studies presented at the 2019 ASCO Annual Meeting. In states that adopted Medicaid...

health-care policy
issues in oncology

2019 ASCO: Medicaid Expansion and Time to Treatment in African American Patients Compared to White Patients With Cancer

Previous racial disparities in timely cancer treatment between African American and white patients were reduced in states where Medicaid access was expanded under the Affordable Care Act (ACA), according to a new analysis of electronic health records from for 30,000 patients. The study, based on...

gynecologic cancer
health-care policy

2019 ASCO: Effect of ACA Implementation on Diagnosis and Treatment of Ovarian Cancer in Women Under 65

An analysis of data from the National Cancer Database found that after implementation of the 2010 Affordable Care Act (ACA), ovarian cancer was diagnosed and treated at an earlier stage among women younger than age 65. More women also received treatment within 30 days of diagnosis, thereby...

issues in oncology
health-care policy

Amy J. Davidoff, PhD, on Racial Disparities in Time to Cancer Treatment: The Effect of Medicaid Expansion

Amy J. Davidoff, PhD, of Yale University School of Public Health, discusses study findings on how expanding access to Medicaid through the Affordable Care Act (ACA) reduced racial disparities among patients with advanced cancer. Before the ACA was implemented in 2014, black patients with cancer were less likely than white patients to receive timely treatment, but in states that did not adopt Medicaid expansion, racial disparities persist (Abstract LBA1).

Pain Management
Health-Care Policy

Debating the Role of Opioids in the Management of Chronic Cancer Pain

Despite the increasing public awareness of the danger of the overuse of prescription opioids, drug overdose deaths continue to rise in the United States. According to the Centers for Disease Control and Prevention (CDC), from 1999 to 2017, nearly 400,000 people died of an overdose involving...

Health-Care Policy
Breast Cancer

FDA Advances Policy Changes to Modernize Mammography Services

ON MARCH 27, 2019, the U.S. Food and Drug Administration (FDA) announced important new steps to modernize breast cancer screening and help empower patients with more information when they are considering important decisions regarding their breast health care. For the first time in more than 20...

health-care policy
cost of care

AMA Commends Final CMS Rule for Requiring Pricing Information in TV Drug Ads

Today, Health and Human Services Secretary Alex Azar announced a final rule from the Centers for Medicare & Medicaid Services (CMS) that will require direct-to-consumer television advertisements for prescription pharmaceuticals covered by Medicare or Medicaid to include the list price—the ...

health-care policy
hematologic malignancies
immunotherapy

ASH President Comments on Medicare Proposal for CAR T-Cell Therapy

Earlier this week, the Centers for Medicare & Medicaid Services (CMS) proposed to improve the reimbursement currently given to hospitals that provide chimeric antigen receptor T-cell (CAR-T) therapy to patients with blood cancer as part of the Fiscal Year 2020 Inpatient Prospective Payment...

health-care policy
issues in oncology

Study Finds Medicaid Reimbursement for Radiation Therapy Varies Widely State-to-State

A new study found wide state-to-state variations in Medicaid reimbursements to physicians who treat patients with cancer with radiation therapies. These differences could compound existing disparities in access to health care in rural communities, which tend to have higher Medicaid...

health-care policy

HHS Secretary Appoints Norman E. Sharpless, MD, as FDA Acting Commissioner

Today, the Secretary of Health and Human Services (HHS) Alex M. Azar II appointed Norman E. Sharpless, MD, to be the acting Commissioner of the U.S. Food and Drug Administration (FDA). He will be replacing the current FDA Commissioner, Scott Gottlieb, MD, who announced his resignation on March 5....

colorectal cancer
health-care policy

Effect of Affordable Care Act’s Medicaid Expansion on Colorectal Cancer Screening and Survival in Kentucky

Kentucky has been one of the most successful states in reducing its uninsured rate, which happened in part through the Affordable Care Act’s Medicaid expansion that took effect on January 1, 2014. In the past, Kentucky has reported low rates of colorectal cancer screening, and has ranked ...

Issues in Oncology
Health-Care Policy

‘Curve 2’ and Oncology: What Those in Charge Don’t Understand … or Ignore

THERE IS little doubt that the U.S. health-care system is under assault from many directions.1 It is clear that the costs of health management are no longer sustainable, and the United States has one of the highest per capita health costs among the 36 member nations of the Organisation for...

health-care policy
immunotherapy

CMS Proposes Medicare Coverage With Evidence Development for CAR T-Cell Therapy

Today, the Centers for Medicare & Medicaid Services (CMS) proposed coverage of U.S. Food and Drug Administration (FDA)–approved chimeric antigen receptor (CAR) T-cell therapy under its “coverage with evidence development” paradigm. Currently, there is no national...

health-care policy
issues in oncology

More Than 60 Leading Health-Care Organizations Call on CMS to Maintain Coverage for Medically Necessary Cancer Testing

Leading health-care companies and organizations representing patients, providers, academic medical centers, laboratories, and diagnostic manufacturers urged the Centers for Medicare & Medicaid Services (CMS) to revise its interpretation of the National Coverage Determination (NCD) for...

health-care policy
lung cancer

Shared Decision-Making and Use of Low-Dose CT Screening for Lung Cancer

In a study reported in a research letter in JAMA Internal Medicine, Goodwin et al found that only a small proportion of Medicare enrollees undergoing low-dose computed tomography (CT) screening for lung cancer had a prescreening shared decision-making session, which is mandated by the Centers for...

health-care policy
issues in oncology

Over 40 Medical Organizations Call for an End to the Government Shutdown

Forty-six medical advocacy organization and professional societies have called on President Donald Trump, Speaker of the House Nancy Pelosi, Senate Majority Leader Mitch McConell, Senate Minority Leader Chuck Schumer, and House Minority Leader Kevin McCarthy to end the government shutdown and, in...

Issues in Oncology
Legislation
Health-Care Policy

New Regulations Require Better Communication With Patients Who Have Disabilities and Limited English Proficiency

Ever since President Barack Obama signed the Patient Protection and Affordable Care Act (ACA) into law on March 23, 2010, the nondiscrimination provision of the law, Section 1557, which prohibits discrimination on the basis of race, color, national origin, sex, age, or disability in certain health ...

Issues in Oncology
Health-Care Policy
Legislation
Cost of Care

Will the Trump Administration’s Plan to Reduce Cancer Drug Prices Work?

High drug prices are the number one health-care concern of many Americans. The average price of a cancer drug rose from less than $10,000/yr before 2000 to more than $170,000/yr in 2017.1-3 Between 1995 and 2013, the launch price of cancer drugs increased by 10% to 12% every year, and the average...

Issues in Oncology
Health-Care Policy

Health-Policy Forum Focuses on New Care-Delivery Paradigms

What was an MBA doing at the podium of a clinical oncology meeting? Ten years ago or so, that might have been surprising. But in an era of rapid change—in therapies, costs, payment models, and practice—it only makes sense. Amy Porter-Tacoronte, MBA, Health System Chief Administrative Officer at the ...

Issues in Oncology
Health-Care Policy

Medicaid Work Requirements Could Reduce Vulnerable Patients’ Access to Cancer Care

In a recent position statement, ASCO warns that Medicaid work requirements may hinder patient access to essential cancer care and reduce the already limited time physicians are able to spend with their patients. ASCO also recommends that federal and state policymakers take specific steps to ensure...

health-care policy
issues in oncology

AACR Releases Annual Cancer Progress Report

The American Association for Cancer Research (AACR) has released its annual Cancer Progress Report highlighting how federally funded research discoveries are fueling the development of new and even more effective ways to prevent, detect, diagnose, and treat cancer. Key advances outlined...

health-care policy
issues in oncology

Medical Groups Release Letter on Proposed Changes to Medicare Physician Payment Rule

The American Medical Association and about 150 medical groups sent the following letter to Seema Verma, Administrator of the Centers for Medicare and Medicaid Services (CMS), regarding the administration’s proposals included in the 2019 Medicare physician payment rule. The full text of...

Health-Care Policy

CMS Proposes Extended 340B Cuts for 2019

ON JULY 25, the Centers for Medicare & Medicaid Services (CMS) released its 2019 Hospital Outpatient Prospective Payment System proposed rule. Among other provisions, the proposal would extend 2018 reimbursement cuts to the 340B Drug Pricing Program to include currently excepted, off-site...

health-care policy
issues in oncology

ASCO Statement: Step Therapy Creates Barriers to Care for Medicare Advantage Beneficiaries With Cancer

Monica M. Bertagnolli, MD, FACS, FASCO, ASCO President, released the following statement today: “ASCO strongly opposes the Centers for Medicare & Medicaid Services (CMS) decision to allow Medicare Advantage plans to employ step therapy across physician-administered and self-administered...

Health-Care Policy

Is Universal Health Care a Human Right?

The Affordable Care Act (ACA) provided oncology services to people with cancer who had previously been denied coverage. And for that reason alone, many oncologists supported its passage. However, even though the U.S. health-care system remains in the crosshairs of partisan politics, parties on both ...

Issues in Oncology
Health-Care Policy

Is the Move to a Value-Based Health-Care Delivery System Feasible?

In 2015, Congress passed the Medicare Access and CHIP Reauthorization ACT (MACRA), which aims to move Medicare toward reimbursement based more on outcomes and values, a goal, in theory, shared by the oncology community. To shed light on the complicated and problematic attempt to restructure the...

health-care policy
cost of care

Cost Differences in Chemotherapy Administration by Site

Critics of health-care consolidation have cited higher costs of chemotherapy administration as an example of how mergers drive up costs. A new study by Kalidindi et al in The American Journal of Managed Care found that although drug administration costs in hospitals are higher,...

gynecologic cancer
health-care policy

Study Evaluates Effects of Affordable Care Act on Young Women With Gynecologic Cancer

The gains in insurance coverage with the Patient Protection and Affordable Care Act (ACA) have already translated into improved health for young women with gynecologic cancers, who are getting diagnosed at earlier stages of their disease because of ACA benefits. That’s the conclusion of a new ...

Health-Care Policy

COA Practice Impact Report Details Consolidation, Shift of Cancer Care System Into Hospital Setting

THE COMMUNITY ONCOLOGY Alliance (COA) has released the 2018 Community Oncology Practice Impact Report,1 which tracks data on the changing landscape of cancer care in the United States. It details a decade-long trend of closure and consolidation in the U.S. cancer system that has resulted in a...

legislation
health-care policy

Roy Herbst, MD, PhD, on Legal and Policy Issues Associated With Cutting-Edge Cancer Treatments

Roy Herbst, MD, PhD, Chief of Medical Oncology, Yale Cancer Center and Smilow Cancer Hospital, speaks during Panel 5: Legal and Policy Issues Associated With Cutting-Edge Cancer Treatments at The Policy, Politics and Law of Cancer, presented by The Solomon Center for Health Law and Policy at Yale Law School, in collaboration with Smilow Cancer Hospital and Yale Cancer Center.

health-care policy
issues in oncology

COA Practice Impact Report Details Consolidation, Shift of U.S. Cancer Care System Into More Expensive Hospital Setting

The Community Oncology Alliance (COA) has released the 2018 Community Oncology Practice Impact Report, which tracks data on the changing landscape of cancer care in the United States. It details a decade-long trend of closure and consolidation in the U.S. cancer system that has resulted in a...

issues in oncology
health-care policy
legislation

Charles Sawyers, MD, on Legal and Policy Issues Associated With Cutting-Edge Cancer Treatments

Charles Sawyers, MD, Chair, Human Oncology and Pathogenesis Program, Memorial Sloan Kettering Cancer Center, speaks during Panel 5: Legal and Policy Issues Associated With Cutting-Edge Cancer Treatments at The Policy, Politics and Law of Cancer, presented by The Solomon Center for Health Law and Policy at Yale Law School, in collaboration with Smilow Cancer Hospital and Yale Cancer Center.

health-care policy

Richard Schilsky, MD: Is the Federal Government a Productive Partner in Cancer Policy?

Richard Schilsky, MD, Chief Medical Officer, ASCO, speaks during Panel 1: Is the Federal Government a Productive Partner in Cancer Policy? at The Policy, Politics and Law of Cancer, presented by The Solomon Center for Health Law and Policy at Yale Law School, in collaboration with Smilow Cancer Hospital and Yale Cancer Center.

health-care policy

Nancy Goodman, JD, MPP: Is the Federal Government a Productive Partner in Cancer Policy?

Nancy Goodman, JD, MPP, Executive Director, Kids V Cancer, speaks during Panel 1: Is the Federal Government a Productive Partner in Cancer Policy? at The Policy, Politics and Law of Cancer, presented by The Solomon Center for Health Law and Policy at Yale Law School, in collaboration with Smilow Cancer Hospital and Yale Cancer Center.

health-care policy

Nancy Goodman, JD, MPP: Is the Federal Government a Productive Partner in Cancer Policy?

Nancy Goodman, JD, MPP, Executive Director, Kids V Cancer, speaks during Panel 1: Is the Federal Government a Productive Partner in Cancer Policy? at The Policy, Politics and Law of Cancer, presented by The Solomon Center for Health Law and Policy at Yale Law School, in collaboration with Smilow Cancer Hospital and Yale Cancer Center.

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