2014 COA Community Oncology Conference Coverage

Our friends at OBR Oncology have posted a full report of the 2014 COA Community Oncology Conference. In their coverage they have a number of videos including a discussion of What’s Impacting Cancer Care? with COA’s own Executive Director Ted Okon, a Community Oncology 2.0 Medical Home Report with Dr. Daniel McKeller, MD, and How to Innovate Within Oncology Payment Reforms with Stuart Genschaw, Exec. Dir. There is also a full recap of both conference days events. Please check out the coverage and videos at their website OBR Oncology by clicking here.

New Jerseyans Find It Hard To Find Doctors Who Accept Their Insurance

By ANDREW KITCHENMAN

Quest for physicians who take their health coverage proves much more difficult for NJ residents compared to national average

New Jersey residents are more than four times as likely as the national average to have difficulty finding a doctor who accepts their health insurance, according to a new Rutgers University report.

Of state residents between the ages of 18 and 64, 14.6 percent reported having trouble finding a doctor who would accept their insurance, while 9 percent of those 65 and older had difficulty.

These numbers are much higher than the national averages of 3.3 percent of those 18 to 64 and 2.1 percent of those 65 and older. The figures are from a Rutgers Center for State Health Policy report, which drew on a state survey of residents.

While the numbers are troubling, center Director Joel Cantor said the reason for the disparity isn’t clear. He said further study of the issue is needed.

“It’s possible that there’s a fair number of physicians in New Jersey who don’t accept Medicare,” as well as private insurance, said Cantor, noting that problem was found across all age groups.

The Rutgers report is the fourth in a series intended to provide more state-level information on the implementation of the Affordable Care Act here.

It aims to provide a baseline to understand what the state’s needs were before the January expansion of health insurance through the federal marketplace and Medicaid eligibility expansion.

“It really grows out of the concern that as the number of people with health insurance increases, that there will be stress on the physician supply,” said Cantor, who is an NJ Spotlight columnist.

The state Behavioral Risk Factor Surveillance System survey that the report was based on was conducted between January 2012 and June 2013.

Cantor said that it’s possible that the relatively high percentage of people who had difficulty finding a doctor who accept their insurance may be because New Jersey residents having higher expectations.

But it’s “more likely that New Jersey physicians are less likely to accept all comers,” Cantor said.

Most state residents didn’t have a problem finding a general doctor, such as a primary-care doctor, who accepted their insurance. The report found that only 5.1 percent reported having difficulty finding a general doctor, including 1.8 percent who never found one.

More residents reported difficulty finding a specialist who took their coverage, with 6.4 percent having difficulty, including 2.5 percent unable to find a specialist.

Not surprisingly, the problems were greatest for people insured through New Jersey FamilyCare or Medicaid, which reimburse doctors at a much lower rate than Medicare or private insurers. Of Medicaid recipients, 9.5 reported having difficulty finding a general doctor and 13.6 reported problems finding a specialist.

“That’s consistent with other studies, not only in New Jersey, but around the country,” Cantor said.

The percentage of people who reported being told by a doctor that their insurance wasn’t accepted was higher than the percentage of those who reported having difficulty finding a doctor.

People with frequent mental-health problems were among those with the greatest difficulty finding access to doctors. Of those who reported having four or more “bad mental health days” in the prior month, 19.6 percent said a general doctor told them that their health insurance wasn’t accepted, while 18.8 percent had that experience with a specialist.

“It raises questions about the network adequacy” of these patients’ insurance plans, Cantor said. Insurers are legally required to provide an adequate network of providers.

The challenge that some New Jerseyans have in finding a doctor wasn’t a surprise to the New Jersey Academy of Family Physicians, according to Raymond J. Saputelli, academy executive director.

“I think as good as it is for the state to see more people covered as a result of the ACA, I think it’s only going to exacerbate the problem,” said Saputelli, referring to various financial pressures on family doctors.

Saputelli noted that New Jersey is a “net exporter” of family doctors, with the number of physicians trained in the state exceeding the number who chose to practice in it.

“They leave school with a tremendous amount of debt and when they look at the potential for paying that debt, the payment is far inferior in New Jersey,” Saputelli said.

Saputelli said the high cost of practicing in the state threatens to make New Jersey a “primary-care desert.” The academy wants the state government to reduce family doctors’ medical school debt, among other steps to encourage them to practice in the state.

“The primary-care environment in the state is toxic to family medicine,” he said. “I think the ACA — as hopeful as it might be in terms of covering people — is going to expose and exacerbate the creation of that desert pretty quickly if we don’t change some things. “

He also noted the poor Medicaid reimbursement rate in the state. Medicaid fees amount to only 45 percent of Medicare reimbursement rates in the state, which is the second-lowest ratio in the country, behind only Rhode Island, according to Kaiser Family Foundation statistics.

The Rutgers Center for State Health Policy plans to continue to study residents’ access to doctors as the number of people with insurance increases. In 2011, Cantor and other Rutgers researchers estimated that 444,000 state residents would gain insurance as a result of the ACA.

Cancer Doctors Plan to Compare Value of Expensive Drugs

By Sasha Damouni and Robert Langreth

The world’s largest organization of cancer doctors plans to rate the cost effectiveness of expensive oncology drugs, and will urge physicians to use the ratings to discuss the costs with their patients.

The American Society of Clinical Oncologyis weighing efficacy, side effects and price using an algorithm to determine the relative value of drugs, focusing first on therapies for advanced cases of lung and prostate cancer and for multiple myeloma, said Richard Schilsky, the group’s chief medical officer. The task force developing the system plans to present it for public comment later this year, he said. (more…)

ASCO Releases First Three Guidelines on Cancer Survivorship Care

The American Society of Clinical Oncology (ASCO) today issued three evidence-based clinical practice guidelines on the prevention and management of symptoms that affect many cancer survivors—neuropathy, fatigue and depression, and anxiety. The guidelines are the first three in a planned series of guidelines on survivorship care. The recommendations reinforce the need to care for the both physical and psychological needs of cancer survivors. (more…)

Wonkbook: Why Doctors Are Upset About The Medicare Payment Data Release

Wonkbook’s Number of the Day: $121 million. That’s the sum of what the top 10 billers charged for Medicare in 2012.

Wonkbook’s Chart of the Day: This chart shows a close relationship between wage inequality among women and the minimum wage.

Wonkbook’s Top 5 Stories: (1) The limitations on that Medicare data; (2) what the Fed minutes tell us; (3) the pay-gap debate isn’t going away for now; (4) Congress’ corporate accountability clout; and (5) how Democrats are pushing immigration action.

(more…)

Meet The Woman Who Is About To Become The Biggest Name In Health Care

BY JASON MILLMAN

FILE - APRIL 10, 2014: President Obama to nominate Office of Management and Budget Director Sylvia Mathews Burwell to replace Health and Human Services Secretary Kathleen Sebelius. WASHINGTON, DC - MARCH 04:  Sylvia Mathews Burwell, the President of the Walmart Foundation, listens as U.S. President Barack Obama announces her nomination budget director during a ceremony in the East Room of the White House March 4, 2013 in Washington, DC. The nominations will be key appointments for Obama's second term while focusing on the issues of the national budget as well as energy and climate issues.  (Photo by Win McNamee/Getty Images)

OMB Director Sylvia Mathews Burwell (Photo by Win McNamee/Getty Images)

Sylvia Mathews Burwell is about to become the biggest name in health care after news broke Thursday night that she will be the nominee to replace the resigning Health and Human Services Secretary Kathleen Sebelius.

If confirmed, Burwell, who is the current director of the Office and Management and Budget, will become the key figure leading implementation of the Affordable Care Act at a crucial time for the health-care law during a hotly contested election year.

(more…)

COA Issues Statement on Release of Medicare Data

COA strongly disagrees with the release of physician-specific Medicare reimbursement claims data and the manner in which CMS released the data. You can read the statement issued by COA here.

Sebelius To Resign As HHS Chief

By Elise Viebeck, Jonathan Easley and Justin Sink

Health and Human Services Secretary Kathleen Sebelius will resign from President Obama’s Cabinet on Friday, ceding her role as the top official in charge of ObamaCare.

Obama intends to replace Sebelius, who has come under fire for the botched rollout of the federal ObamaCare exchange, with Sylvia Burwell, the director of the Office of Management and Budget. The announcement will be made at the White House on Friday morning.

Sebelius’s long-expected departure comes just two weeks after the end of ObamaCare’s first enrollment period, which culminated in the administration exceeded its original target of enrolling 7 million people in the exchanges. (more…)

To Spark Cancer Discoveries, Several Big Pharma Companies Are Sharing Idle Clinical Trial Data

by 

Big Pharma spends billions of dollars each year researching, developing and testing new treatments for cancer. In the meantime, it’s also collecting millions of data points that figuratively sit on a shelf and collect dust once a clinical trial is complete.

A consortium of Big Pharma companies and research organizations are attempting to give that raw data a second life by making it available to researchers on the new Project Data Sphere platform.

The not-for-profit PDS initiative was designed to be a single place where the cancer research community can share and analyze data. Specifically, it’s housing de-identified, patient-level data from late-stage comparative studies. (more…)

Forget About Obamacare Exchanges. Employer Coverage Is Booming, Survey Finds

BY JASON MILLMAN

While the political world has spent the past several months watching enrollment numbers in Obamacare health insurance marketplaces, maybe we should have been focusing on employer-sponsored insurance.

A new survey from Rand Corp. estimates 9.3 million people were newly insured between September 2013 and March 2014, a trend that was mostly driven by an enrollment increase in employer-sponsored plans. (more…)