Advanced-stage cancer diagnoses declined following health insurance expansion in Massachusetts, likely due to increased access to screening and diagnostic services that identified cancers earlier, according to new research published by Sabik et al in the journal Medical Care. The analysis...
On January 27, the Centers for Medicare & Medicaid Services (CMS) took action to cover U.S. Food and Drug Administration–approved or –cleared laboratory diagnostic tests using next-generation sequencing (NGS) for patients with germline ovarian or breast cancer. Over the last several years, CMS ...
In a study reported in JAMA Oncology, Trevor Royce, MS, MD, MPH, and colleagues found that publicly available information on pricing for radiation treatment for prostate cancer was complex and inconsistent, and that pricing varied widely among National Cancer Institute (NCI)-designated cancer...
In a study reported in a research letter in JAMA Oncology, Emily Stamell Ruiz, MD, MPH, and colleagues found that rising drug costs and use accounted for 56% and 44%, respectively, of increased Medicare Part D spending on oral anticancer drugs between 2013 and 2017. Study Details The analysis...
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,...
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...
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...
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).
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...
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...
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...
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.
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 ...
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...
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 ...
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...
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...
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...
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 ...
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...
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...
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...
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).
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...
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...
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 ...
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...
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...
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....
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 ...
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...
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...
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...
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...
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...
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 ...
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...
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 ...
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...
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...
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...
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...
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...
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 ...
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...
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,...
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 ...
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...
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.
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...