Community Cancer Clinic Closings on the Rise

U.S. Cancer Care Delivery System Crumbling

WASHINGTON, July 14 /PRNewswire-USNewswire/ -- The Community Oncology Alliance (COA) today announced that due to severe year after year cuts to Medicare reimbursement for cancer care, community oncologists around the U.S. are closing offices at a rate rapidly increasing since January 2010.  Reductions in staff, services and facilities are also on the rise.(1)  

Specifically, 39 community cancer clinics in 15 states across the U.S. have closed or are in the process of closing since this January 2010 date due to financial pressures from severe cuts in Medicare reimbursement for cancer care. If this trend continues, the number of closures could double by the end of this year. A recent casualty is the cancer clinic serving Selma, Alabama for nearly 25 years that was forced to shut its doors to patients.  In total, 166 clinics have closed over the past three years.  

"As a practicing oncologist, I am extremely concerned about the impact these closings have on patients. Many are simply falling through the cracks as providers are being forced to cut staff and close clinics, forcing patients to seek treatments outside of their communities," said David Eagle, MD, newly elected President of the Community Oncology Alliance (COA).  

In the past few years, more than 850 clinics nationwide have experienced severe negative impacts from annual cuts to cancer care by Medicare.  This number includes clinics that have closed their doors; continue struggling financially to pay bills to operate; are forced to send all of their Medicare patients elsewhere for treatment; or have been acquired by hospitals or other entities.

As a result, a growing number of cancer patients are unable to receive care in their communities, and many cannot travel the distances required to get treatment. Rural practices and those with higher proportions of Medicare and Medicaid patients are particularly hard hit.  Four out of five U.S. cancer patients are treated in the community setting, and approximately half of all U.S. cancer patients are Medicare patients.(2)(3)

"Delays in resolving major Medicare cuts to all physicians have compounded the very serious problems already facing community oncology practices due to continued payment cuts to cancer care," said Ted Okon, Executive Director of COA.  "We are seeing community oncology offices cutting staff, services, and ultimately closing at a much faster pace since the beginning of 2010.  The economic reality is that practices cannot continue to operate when their costs are greater than revenues.  This country has the best, most efficient cancer care delivery system in the world, yet unrealistic payment policies are pushing it off a cliff.  This is nothing less than a national crisis."

Compounding the problem, the nation is losing oncologists relative to the mandate for cancer care.(4)  By 2020, there will be a shortage of 4,080 oncologists, causing cancer patient demand to outstrip the supply.(5)  It is estimated that by 2020, one in four cancer patients will be short an oncologist.  Additionally, as oncologists retire, fewer physicians are choosing to treat cancer.  National Analysts reported that one in five (20%) oncologists would discourage a medical student/resident from pursuing a career in oncology, versus only 3% who would have done so in 2003, prior to the problems caused by year-over-year Medicare cuts.(6)

The cancer mortality rate in the U.S. has declined due to earlier detection, the quality of treatment, and the accessibility of cancer care.  The American Cancer Society's just-released Cancer Statistics 2010 estimates that 767,000 U.S. lives were saved from 1990-2006 by reducing the cancer death rate.(7)  Yet, cancer is still the number one killer of Americans under age 85.

"The government has to act now to stop Medicare cuts in order to preserve our nation's cancer care delivery system before it's too late," said Okon.  

About Medicare Cuts to Cancer Care

Medicare has already severely cut payments for cancer care, dramatically impacting doctors' ability to treat patients.  For example, Medicare payment for the administration of chemotherapy has been cut by 35% since 2004, which is an effective cut of 47% when factoring in the increase in the Medical Economic Index (MEI).  Medicare will make additional payment cuts in 2011, 2012, and 2013.  A study completed by Avalere Health shows that Medicare covers only 57% of the cost of providing this critical component of cancer care.  Payment cuts are also being made to imaging tests — such as PET and CT scans — and there will be a 23.5% payment cut for all physicians' services effective December 2010 and a 6.1% cut effective January 2011, if Congress does not act to stop these cuts.

About Community Oncology Alliance (COA)

Formed in 2003 in response to the Medicare Modernization Act, COA is a non-profit organization dedicated solely to community oncology.  COA was founded by community oncologists to advocate for patients and providers in the community oncology setting, where four out of five Americans with cancer are treated.

Currently, COA is working with Congress in providing proactive solutions designed to protect the viability of the nation's cancer care delivery system and patients' access to quality, affordable cancer care.  The cancer death rate in the U.S. has declined due to earlier detection, the quality of treatment, and the accessibility of cancer care. However, according to the American Cancer Society, men still have an approximately one in two lifetime risk of developing cancer, with a risk of one in three for women. For more information, please visit

(1)  Based on the Community Oncology Alliance cancer impact database compiled from data from private and public sources. (2007 – current)

(2) NCI Community Cancer Centers Program (NCCCP). Pilot Program Summary. 2007

(3) Avalere Health. Providing High Quality Care in Community Oncology Practices: An Assessment of Infusion Services and Their Associated Costs. February 2010

(4) Erikson et al, "Future Supply and Demand for Oncologists: Challenges to Assuring Access to Oncology Services" Journal of Oncology Practice. 2007 2:79-86

(5) Ibid.

(6) National Analysts Worldwide. Oncologists Look at Oncology: The Prognosis for US Cancer Care. September 2008

(7) Jemal, et al.  "Cancer Statistics, 2010,"  CA: A Cancer Journal for Clinicians: 2010:60(5)  

SOURCE Community Oncology Alliance