Patients and Doctors Oppose the Part B Proposal: They Want to Choose


If you've read the news lately, you may have noticed talk of changes to some of the Center for Medicare and Medicaid Services' (CMS) programs. CMS, the federal office that oversees the administration of key public health care services, recently proposed changes to the way it values and compensates physicians that will have a serious impact on patients access to particular medicines.

CMS recently proposed experimental changes to its current Part B Drug Payment Model, which vary the levels of reimbursement physicians will get, depending on where they live, for certain medication-based treatments. The current model keeps out-of pocket costs low for patients accessing treatments that work best for them. The new, experimental model would focus on cutting costs rather than improving patient outcomes or improving quality of care. This will lead to different standards of care based on where a patient lives, limit treatment options in certain areas and potentially increase costs to the patient. While the intent of this plan may be well founded, a large shift in protocol like this one would do more harm than good.

Most of us believe that health care is most effective when patients and their doctors work together to decide the best course of treatment. The current CMS proposal would undermine patient care in some of the most vulnerable therapeutic areas covered under Part B, like cancer, rheumatoid arthritis and immune deficiency diseases. Removing patients' control of their own care creates serious barriers to access to treatment, and many of the patients themselves are speaking up about it. A new survey from Partnership to Improve Patient Care found that most patients overwhelmingly oppose further government involvement in their health care choices, and do not believe others should decide what medicines work best for them. Here's what they had to say:

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The feedback is clear - patients want to make their own choices.

Medicare Part B provides millions of Americans with a wide variety of much needed services like outpatient care, medical equipment and physician-administered medicines like vaccinations or chemotherapy. These services are extremely valuable to patients, but don't come with a hefty price tag. Part B eligible treatments make up just 3% of total Medicare spending. If CMS needs to cut costs or reevaluate cost effectiveness, they've started in the wrong place.