Gines, Riccobono: Medicare cuts are a raw deal for Wisconsin seniors

Thanks to incredible advances in medicine, the 285,000 Wisconsinites battling cancer face better odds of beating the disease than ever before. Since 1995, Wisconsin's cancer mortality rates have dropped 23% for men and 14% for women.

Unfortunately, a federal advisory panel is urging lawmakers to cut Medicare Part B, the program that covers chemotherapies, immunotherapies and other advanced drugs that must be administered by doctors. If Congress implements this recommendation, these trends could reverse, as Wisconsin seniors would lose access to life-saving medications.

Under Part B, health care providers purchase medicines up front and are then reimbursed by the government. Historically, Medicare would pay providers for the average cost of the treatment plus 6%, an add-on designed to cover handling, storage and administration. That fee dropped to 4.3% under the 2013 budget sequester.

Doctors, patients and many lawmakers pushed hard against that cut, fearing it would drive health care providers out of business. They were right. Yet the Medicare Payment Advisory Commission — a federal panel that advises Congress on Medicare — recently recommended slashing reimbursement rates even further.

Many health care providers would not be able to continue providing Part B medications if reimbursement rates were lowered. A month after reimbursement rates were cut in 2013, for example, one study found that nearly half of oncology practices turned away Medicare patients who did not have supplemental insurance. In addition, 14% of these practices stopped seeing Medicare beneficiaries altogether.

If Part B reimbursements are cut, clinics might close down. Past cuts to reimbursements led to a 20% increase in both cancer facility closings and hospital mergers or acquisitions. Since 2008, 380 cancer clinics across the country have closed their doors. Another 390 have struggled to keep theirs open. In Wisconsin, 30 clinics have closed or been acquired by a hospital.

Wisconsin's rural communities already face limited health care options. A quarter-million Wisconsinites live more than 15 miles away from a hospital.

If the elderly lose their local clinics or hospitals, they may have to travel even longer distances to find another one. The financial and time burdens of long commutes could prevent ill seniors' caregivers from driving them to treatment centers, especially since most Part B medications have to be taken weekly or biweekly.

And in Wisconsin, a closed rural clinic or hospital means more than just the loss of treatment. Many small towns rely on these facilities to drive the economy and provide their residents with jobs. So as Rural Wisconsin Health Cooperative Executive Director Tim Size recently said, "If you lose a rural hospital, you close the town."

Lawmakers ought to ignore MedPAC's recommendations. Cutting Part B reimbursements would lead to reduced care for our seniors, especially for those living in rural areas.

Sandra Gines is executive director of the Wisconsin Breast Cancer Coalition (wbcc@wibreastcancer.org). Carrie Riccobono is chair of government relationsof the Southeastern Wisconsin Oncology Nursing Society (http://swons.vc.ons.org/)