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The Festering Sequester

June 2013, Vol 3, No 4

The statistics are startling.

Initial survey results from the Association of Community Cancer Centers (ACCC) show that nearly 60% of the respondents say they’ve made significant changes in how they run their practices just in the past 3 months (see our story on page 31).

A separate survey by the Com­munity Oncology Alliance (COA) found that 49% of community oncology practices have been forced to send their Medicare patients elsewhere for treatment, a number that is projected to increase to 62% if the sequester is still in place on July 31.1 That same survey also revealed that 21% of oncology practices are already laying off staff, with that number also projected to rise to 38% if the sequester goes beyond July 31.

The American Society of Clinical Oncology (ASCO) also found disturbing sequester-related data, reporting in its online survey that just 1 month later, an overwhelming 80% of the respondents were already being impacted by the mandatory 2% across-the-board budget cuts that went into effect on April 1, with 74% of oncology practices having enough difficulty paying for chemotherapy drugs that they were forced to turn patients away. Some practices and clinics were sending up to half of their Medicare patients elsewhere, such as to expensive hospital-based infusion centers.2

Clearly, the effects of the sequester are being felt in oncology, and, in truth, they were felt early on. Barely 3 days after the sequester went into effect, The Washington Post reported that oncology clinics were already turning Medicare patients away. The chief executive of North Shore Hematology Oncology Associates in New York, Jeff Vacirca, was quoted as saying that if they treated their Medicare patients with the most expensive drugs, they’d “be out of business in six months to a year.” After looking at the math and holding an emergency meeting, North Shore made the difficult decision to no longer see 16,000 of their Medicare patients with cancer.3

It is no surprise, then, that cancer care providers, oncology practice managers, healthcare policymakers, and patients with cancer are all paying attention, and with great interest, to how a new bill progresses through Congress in the coming weeks and months. The Cancer Patient Protection Act of 2013 (H.R. 1416), which was introduced by Rep. Renee Ellmers, R-NC, in early April, was being cosponsored by 88 members of Congress (both Republicans and Democrats) as we went to press. The bill would exempt Part B drugs, including cancer and supportive care drugs, from the 2% sequestration cut. However, a check of the bill on GovTrack ( shows it has only a 10% chance of making it past committee and a 6% chance of being enacted (as of press time).

As the sequester wears on, these collective survey results indicate that every cancer care provider and patient with cancer will be, at some point and in some way, negatively impacted by the standstill in Washington. As a leading resource for information relating to all aspects of managing the business of an oncology practice, the editors, staff, and publishers of Oncology Practice Management will stay on the forefront of breaking news and developments that could impact your practice and your patients. With news and viewpoints from the ACCC, COA, ASCO, and other groups on the front line of shaping cancer care policy, we will keep you up to date on any legislative movements from Washington as well as offer valuable perspectives on how oncology practices everywhere are dealing with the impact. We invite you to join this national conversation by sharing your own experiences in your own practices. If you have a story to share, please e-mail OPM’s Editorial Department at This email address is being protected from spambots. You need JavaScript enabled to view it.. We plan to share some of your stories in future issues. Thank you for reading, and thank you for your continued support of OPM.

1. Community Oncology Alliance. Sequestration cuts threaten seniors’ cancer care while increasing Medicare costs. Available at http://www.commu Accessed June 13, 2013.
2. American Society of Clinical Oncology. ASCO sequestration impact survey: One month out, sequestration affecting care of Medicare cancer patients [press release]. May 9, 2013.
3. Kliff S. Cancer clinics are turning away thousands of Medicare patients. Blame the sequester. The Washington Post. April 3, 2013.

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