Medicare officials proposed Tuesday to test new ways of
reimbursing doctors who administer drugs in their offices and hospital
outpatient clinics, with a long-term goal of encouraging greater use of
treatments that are high quality but less costly.
The
proposal by the Centers for Medicare and Medicaid Services would apply
to Medicare Part B, which covers drugs such as infused cancer
medications and injectable antibiotics. Last year, Medicare spent about
$20 billion on Part B drugs.
Patrick Conway, chief
medical officer for CMS, said in a telebriefing that the plan isn’t
designed to save money. But he left little doubt that the ultimate aim
is to eliminate incentives that may encourage doctors to select
higher-priced medications that benefit their bottom lines but not their
patients. Conway called the current system, in which doctors are paid the average
sales price plus 6 percent for handling and administration costs, a
“perverse incentive structure that doesn’t benefit patients or the
system.” He said oncologists have told CMS they sometimes feel pressure
from their health-care systems to pick more expensive drugs to bolster
profits.
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