[March 11, 2014]WASHINGTON (Reuters)
— U.S. cancer doctors are
worried about their ability to handle an expected surge in cancer
cases in the coming years as they face cuts to government health
plans and efforts to reduce payments to physicians.
The influential American Society of Clinical
Oncology, in a report released on Tuesday, cited estimates that
cancer will become the leading killer in the United States by 2030
as the population ages, while treatment costs reach new heights. The
group is calling on the U.S. Congress to help stabilize payments to
doctors under the Medicare insurance program for the elderly.
"What you are seeing from Medicare as well as others is they
continue to constrain the revenues to practices. At the same time,
the number of patients everyone is seeing is going up as the
population increases," said Blase Polite, an oncologist at the
University of Chicago.
"Combine that with the cost of the care that we're providing ...
It's really creating a very difficult financial situation," Polite,
incoming head of government relations for ASCO, told Reuters.
A projected workforce crunch could also hamper care as demand for
cancer treatment rises, ASCO said in the report summarizing its
survey of 1,162 oncology practices in 2012 and 2013 representing
more than 13,000 physicians. Overall, ASCO represents 35,000
doctors, nurse practitioners, researchers and other cancer care
Its survey, to be unveiled in a briefing on Capitol Hill later on
Tuesday, comes as Congress grapples with how to address looming
physician payment cuts ahead of a March 31 deadline.
ASCO and other physician groups have been pressing Congress for
years to alter the reimbursement formula known as the sustainable
growth rate, or SGR. The U.S. House of Representatives plans to vote
on a replacement on Friday.
About 14 million people in the United States have had cancer, and
the American Cancer Society estimates that nearly 1.7 million people
will be newly diagnosed in 2014 and more than 585,000 will die from
By 2030, the rate is expected to jump to 2.3 million new cases each
year, ASCO said in its report. The number of those who previously
had cancer and survived is also expected to grow.
ASCO President Clifford Hudis said he does not see the group's push
taking away from the needs of other specialty physicians and their
patients. "All of this crisis-to-crisis management has to come to a
stop," Hudis, a breast cancer specialist at Memorial Sloan-Kettering
Cancer Center in New York and a professor of medicine at Weill
Cornell Medical College, said of Congress's efforts.
FIXING THE 'DOC FIX'
Congress is weighing changes to the physician payment system that
calls for sharp cuts in reimbursement to doctors. The system has yet
to be put in place because lawmakers have overridden the legislation
each year. By the end of March, Congress must either repeal the
formula or pass another temporary patch, or "doc fix."
One proposal under consideration would replace the formula with a
0.5 percent annual increase through 2018, then a two-track system
with either a 0.5 percent or a 1 percent rise depending on which of
the two systems providers use. The Congressional Budget Office has
said that measure would increase federal spending by about $138
billion between 2014 and 2024.
Most cancer cases are diagnosed in older Americans, many of whom are
covered by Medicare. Other insurers also look to Medicare when
setting reimbursement rates to doctors.
The ASCO report estimates a possible shortage of more than 1,487
oncologists by in 2025, in part because cancer providers, like their
patients, are aging.
Nearly 14 percent of the U.S. population, or more than 40 million
people, is age 65 or older, 2012 data from the Census Bureau show.
Drug costs are also a worry, ASCO's Polite said, as prices have
risen to $10,000 a month from $1,000 a month in 1990.
Oncologist Sharon Giordano of MD Anderson Cancer Center in Texas
said while the baby boom generation is likely to "put a strain on
the healthcare system," there is room for promoting preventive steps
such as quitting tobacco use or controlling obesity to help reduce
cancer cases, including recurrence.
"Certainly a new diagnosis ... can be really motivating" to make
lifestyle changes, said Giordano, who is an ASCO member but was not
directly involved with the report. "It's never too late."
(Reporting by Susan Heavey; editing by
Michele Gershberg and Mohammad Zargham)