Part B Pilot Congressional Concerns

Evidence Driven Drug Pricing Project
March 31, 2017

A new analysis reviews payment questions posed by Members of Congress regarding CMS’ proposed Part B drug payment demonstration program.

Dr. Bach’s team found no supporting evidence and some contradictory evidence for predictions that the proposed payment formula would negatively impact Medicare beneficiaries and providers. In fact, when focusing on Phase 1 of the proposed demonstration for medical oncology drugs, the most common category of Part B spending, the analysis finds:
1)No evidence that rural providers face higher drug acquisition costs that under a new formula would lead to reduced access;
2)Little likelihood of patient care transferring from doctors’ offices to hospital outpatient departments as a result of the new payment formula; and
3)Unwarranted concerns that this specific payment change would accelerate hospital consolidation of physician practices.
Below please find a link to Dr. Bach’s study.