Health Policy

On August 2, 2011, President Obama signed the Budget Control Act of 2011 into law, the result of a month-long partisan battle over raising the federal debt ceiling and, in the long-term, reducing the federal deficit (Budget ControlAct of 2011. Pub. L. No. 112-25).
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The healthcare reform legislation involves many potential issues that can affect oncology, for example, how minimum benefits are defined. First, there are required minimum benefits that all health plans and other insurers have to meet, and we have to make sure that cancer care is included.
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The journey for healthcare costsavings is a never-ending process. One of the newest healthcare delivery models, which is mandated for Medicare beneficiaries in the healthcare reform law, is the accountable care organization (ACO).
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Frank discussions with patients about their advanced cancer are challenging for physicians and their patients; however, avoiding such interactions is not a viable option, according to the American Society of Clinical Oncology (ASCO).
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There is no end in sight to the rising cost of fighting cancer, according to Medco’s 2011 Drug Trend Report (www.drugtrendreport.com/2011-report), which forecasted the cost of cancer drugs will grow 34% to 42% over the next 3 years.
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A new analysis of the Humana database shows that the 21-gene recurrence score (RS) molecular assay (OncotypeDX; Genomic Health) leads to targeted management of early-stage breast cancer and reduces payer’s costs (Hornberger J, et al. J Oncol Pract. 2011;7[3s]:e38s-e45s).
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On March 30, 2011, the Centers for Medicare & Medicaid Services (CMS) announced its highly anticipated proposed national coverage decision concerning the prostate cancer immunotherapy sipuleucel-T (Provenge; Dendreon).
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On November 2, 2010, the Centers for Medicare & Medicaid Services (CMS) issued its Physician Fee Schedule and Hospital Outpatient Prospective Payment System final rules for 2011.
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