The Community Oncology Alliance (COA) strongly disagrees with the release of physician-specific Medicare reimbursement claims data and the manner in which the Centers for Medicare & Medicaid Services (CMS) released the data. The data is incomplete, biased, without context, and an unrepresentative sample of Medicare reimbursement to oncologists. Supporting documentation of that is listed in the statement accessible below. Further, CMS did not allow physicians an opportunity to confirm the accuracy of individual data and did not conduct any studies to assess how the data will potentially influence consumers, especially senior beneficiaries, about their medical care decision-making.
CMS has stated that “this data release will help beneficiaries and consumers better understand how care is delivered through the Medicare program.” That is impossible given that the data is simply an unscientific and inconsistent sample of reimbursement claims data — it provides no metrics on quality and value. COA believes that the data may well confuse seniors and others with cancer, adding unnecessary angst to an already emotional situation. As physicians we are first taught to do no harm to our patients. The release of Medicare physician reimbursement claims data may possibly result in inaccurate, misunderstood, and even harmful conclusions by cancer patients.
COA strongly supports identifying physicians who may be fraudulently billing Medicare, which should be a top priority of CMS independent of releasing Medicare reimbursement claims data to the general public. COA also equally supports more transparency and accountability in medical care, especially in measuring the quality and value of cancer care. This is evidenced by COA’s Oncology Medical Home initiative and associated payment reform model based on quality and value metrics. Community oncology practices across the country are providing cost-effective cancer care that substantially reduces spending by Medicare and seniors, as documented by numerous national studies. CMS should be empowering cost-effective cancer care in the community setting and providing consumer-friendly quality and value data that will truly help in more informed decision-making. The release of Medicare reimbursement claims data is not a step in that direction.
Click here to read the entire statement, including supporting points.