by Admin | May 19, 2016 5:24 pm
Oncology groups that say 340B hospitals care more about money than low-income people made a revealing disclosure about their level of care for the poor during a hearing on Capitol Hill earlier this year.
Dr. Debra Patt, a Texas private-practice oncologist, was testifying[1] before the House Energy & Commerce Committee on May 17 about Medicare reimbursement. She was there on behalf of the Community Oncology Alliance[2], Texas Oncology, US Oncology Network, and the American Society of Clinical Oncology. Anyone who follows 340B on Twitter knows COA thinks the program is “out of control in hospitals”[3] and “fueling new buildings in most cases, not patients in need.”
Interestingly, Dr. Patt acknowledged that only 5-10 percent of her patients “are covered by Medicaid or are uninsured.” This is not an isolated trend as private-practice oncologists regularly refer poor, uninsured and underinsured patients to the nearest safety-net hospital for chemo infusion.
To get into the 340B program[4], disproportionate share hospitals must be above a statistical baseline[5] such that roughly 30 percent of their patients are on Medicaid and/or are poor and elderly. And that’s a minimum requirement. For those keeping score at home, that’s three times as much as Patt’s practice. And that does not take into consideration the tens of millions of uninsured patients that rely on 340B hospitals for their care.
Hospitals get 340B drug discounts because they take care of large volumes low-income and otherwise vulnerable patients. Private cancer clinics say they are going out of business because they cannot compete with hospital-based clinics that get 340B pricing. A little transparency is in order. Texas Oncology says it represents more than 350 physicians[6] at more than 150 sites across Texas and Oklahoma. US Oncology Network says it represents more than 1,000 physicians[7] in 350 sites of care. That’s a lot of buying power. Perhaps they can shed light on the magnitude of the negotiated discounts they get on drugs and let others decide whether the playing field is as tilted as they allege.
Also, the shift in cancer care from private practice to the hospital setting is driven by a host of factors[8] that have nothing to do with drug reimbursement and 340B pricing. For example, physician reimbursement for visits and procedures is being squeezed and running a practice is expensive and burdensome. Oncologists are hardly the only specialists who are closing their practices in favor of hospital employment or affiliation.
Scaling back 340B at hospitals would hurt the poor and vulnerable patients that private cancer clinics shun:
Serving the poor is what 340B hospitals do[9]. It’s time for all us to unite on the real challenges in cancer care.
Source URL: https://340binformed.org/2016/05/340b-hospitals-serve-poor-patients-cancer-clinics-shun/
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