Statewide view: Protect Part B meds for seniorsMillions of Minnesotans donned pink ribbons in October to support the fight against breast cancer. An estimated 4,260 state residents will be diagnosed this year. More than 600 Minnesotans will die. Like so many debilitating conditions, age is a principal risk factor behind breast cancer. Those seniors battling devastating illnesses rely heavily on Medicare for the treatments they need to survive.
By: Donna Champion, Duluth News Tribune
Millions of Minnesotans donned pink ribbons in October to support the fight against breast cancer. An estimated 4,260 state residents will be diagnosed this year. More than 600 Minnesotans will die. Like so many debilitating conditions, age is a principal risk factor behind breast cancer. Those seniors battling devastating illnesses rely heavily on Medicare for the treatments they need to survive.
But now, Medicare cuts could jeopardize seniors’ access to care. The nearly 322,000 beneficiaries living in rural Minnesota would be especially hard hit. These seniors are less financially secure than their urban counterparts; they already have limited accessible and affordable health-care options.
Our lawmakers must ensure Minnesota’s most vulnerable aren’t left out in the cold.
Especially ominous right now are new cuts to Medicare Part B that Congress may soon consider. These reductions could dramatically reduce patient access to life-saving drugs. Policymakers need to reject any further cuts — or else Minnesotans will suffer.
Not all prescription drugs can be taken at home. A special class of medicines that have to be infused or injected directly into the bloodstream must be administered at the doctor’s office. These physician-administered treatments for cancer, multiple sclerosis and many other diseases are covered by Part B. Doctors purchase these drugs directly and are then reimbursed by Medicare according to a preset formula: the market-based average sale price of the drug plus an additional 6 percent, which is meant to compensate for various overhead costs.
This formula has worked well at controlling Medicare spending. A study by one former director of the Congressional Budget Office showed that the average sale price of medication plus 6 percent reduced Part B drug spending by 7.3 percent in its first year. Annual spending growth rates in subsequent years also were substantially less than overall Medicare expenditures.
The formula, however, has put some strain on doctors. A report from the Medicare Payment Advisory Commission found that most drugs can be purchased below the average sale price plus 6 percent rate, but the difference is “slim.”
And under sequestration earlier this year, Part B reimbursements effectively were reduced to average sale prices plus 4 percent.
Those cuts already have had damaging consequences for Minnesotans. And now lawmakers may soon contemplate further reductions in Part B payments that inevitably would shrink Medicare patients’ treatment options.
Over the past six years, 288 community cancer clinic sites closed nationwide, and more than 400 practices are struggling financially. Another 469 clinics consolidated operations with hospitals. Clinic closures could translate directly into higher costs. The Milliman consulting firm recently calculated that Medicare chemotherapy costs were 14 percent higher in hospitals than in doctors’ offices.
The closure of community treatment facilities causes particular problems in states with large rural populations. More than 1.4 million Minnesotans — 41 percent of our state’s Medicare population — live in rural areas. When local clinics close, rural patients have to travel great distances to receive treatment. Or just go without.
As Minnesotans champion the fight against breast cancer, they also stand up for the millions of Americans who depend on vital treatments covered under Medicare Part B. Seniors battling deadly diseases need these medications to survive.
Some members of Minnesota’s congressional delegation, such as Rep. Erik Paulsen of Eden Prairie, are already on record in support of Part B funding. This is a good start, but we must let all of our state’s representatives know we can’t afford more Part B cuts.
Donna Champion of Greenfield, Minn., is president of the Minnesota State Grange, a nonprofit volunteer, donations and service organization with about 120 members near Rochester, Elk River, Stark, Aitkin, Minneapolis and Nisswa (nationalgrange. org).