Physician Prescribing Behavior Confounds FFS Rate Reductions As Cost Containment Strategy

OPEN MINDS Weekly News Wire Strategic Health Care News A study found that a Medicare reimbursement reduction for outpatient chemotherapy drugs increased outpatient chemotherapy treatment for beneficiaries with lung cancer because physicians changed their prescribing behaviors to maximize Medicare reimbursements. The change in payment rates was included in the 2003 Medicare Prescription Drug, Improvement, and Modernization Act and went into effect in January 2005. It reduced the reimbursement rates paid to physicians for certain chemotherapy drugs and established a reimbursement rate for delivering chemotherapy treatment. Before 2005, about 16.5% of Medicare beneficiaries received chemotherapy within one month of receiving . . .