Patients perceive no significant change in the quality of care for cancer since the United States' government passed the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (MMA) according to a study published in the November 15, 2007 issue of CANCER, a peer-reviewed journal of the American Cancer Society.
The new study, led by Joëlle Friedman from the Duke Clinical Research Institute in Durham, North Carolina, reports that, compared to patients treated before the MMA, there was no difference in the time to and location of treatment for patients with cancer treated after the Act was signed into law. Furthermore, patients remain highly satisfied with their cancer treatment.
In 2003 the MMA was signed into law by President Bush and was the most comprehensive restructuring of the Medicare system since its introduction in 1965. Changes included a new prescription drug benefit, managed care insurer access, and $25 billion allocated to rural hospitals. One key provision, however, was a significant reduction in Medicare reimbursement to healthcare providers that went into effect January 1, 2005. In particular, cancer treatment was targeted with reduction because it was considered by legislators to have been overly generous.
The effect of these reimbursement cuts on patient care has been unclear. On the one hand, a study commissioned by U.S. government found that patients did not perceive any differences in care. However, other anecdotal sources report that oncologists are downsizing their practices in many markets by eliminating nurses and other staff and by closing satellite offices, requiring patients to travel farther for treatment, particularly in rural areas Dr. Schulman and colleagues surveyed 1,421 cancer patients treated before (n=684) and after (n=737) the MMA to compare patients' perceptions of access to and satisfaction with oncologists' care.