News & Updates

June 17, 2014

Impact on Medicare Payments of Shift in Site of Care for Chemotherapy Administration, Berkeley Research Group, June 2014

Two  independent  trends,  acting  in  combination,  are  currently  resulting  in  increased  Medicare  fee-for-service (FFS)  chemotherapy  payments.  The  first  trend  is  a  shift  in  the  site  of  care  for  cancer  patients  from  physicians’  offices to hospital outpatient departments. Several factors contribute to this shift; this study evaluates the effects of  one  of  those  factors —the  acquisition  of  physician-based  oncology  practices  by  340B  hospitals.  The  second  trend  is  higher  Medicare  reimbursement  rates  for  and  greater  utilization  of  chemotherapy  administration  in  hospital  outpatient  departments  compared  to  physicians’  offices.  This  trend  is  driven  by  Medicare  rate  setting policy and hospital utilization patterns and has been reported in studies performed over the last three years.

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Research