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Access brief fact sheets about ASCO, what it takes to deliver chemotherapy, the MMA, and frequently asked questions about the legislation. These backgrounders may be used for your information or delivered to members of Congress, colleagues and patients.
The American Society of Clinical Oncology (ASCO) is the world’s leading professional society of multidisciplinary physicians who treat people with cancer. For 40 years, ASCO has been the leading advocate for quality treatment and services for cancer patients and an authoritative source for reliable information on cancer care issues.
Our Mission: As a 501(c)(3) non-profit organization, ASCO is dedicated to achieving its mission outlined by the organization’s founders in 1964.
ASCO is committed to:
Improving cancer care and prevention;
Advancing the education of physicians and other professionals in the care of patients with cancer and supporting the development of clinical cancer researchers;
Fostering communication among cancer-related medical subspecialties and the exchange of a wide range of research findings related to cancer, including its biology, prevention, diagnosis, staging, treatment, and psychosocial impact;
Advocating public policy that ensures patient access to high-quality cancer care and that supports increased clinical cancer research; and
Assisting oncologists in addressing the challenges of the modern-day practice of oncology.
Our Membership: ASCO has more than 20,000 professional members worldwide, 15,000 of which are in the United States. ASCO’s members specialize in all fields of oncology, including medical, surgical, and pediatric oncology; hematology; and therapeutic radiology.
ASCO’s membership is comprised of:
Clinical oncologists representing all oncology disciplines and subspecialties;
Physicians and health care professionals participating in approved oncology training programs;
Oncology nurses; and
Other health care practitioners with a predominant interest in oncology.
Our Organization: ASCO is governed by an elected Board of volunteer members, which includes representatives from community oncology, academic institutions, and the international oncology community. The Society conducts the majority of its business through various committees comprised primarily of ASCO members who volunteer their time and effort to the Society’s programs. More than 700 volunteers serve on ASCO’s committees and task forces. Patients and leaders of patient advocacy groups are often active in ASCO committees as well.
Contact Us: For more information, contact ASCO’s Cancer Policy & Clinical Affairs Department at 703-299-1050, or by e-mail at publicpolicy@asco.org.
Oncologists, oncology nurses, and other professionals on the cancer care team typically deliver a variety of services to cancer patients related to drug therapy and its side effects. These categories include physician services before and after patient visits, services provided by nurses, as well as vital services furnished by other non-physician staff. It is important to recognize that the services offered to cancer patients in the community setting are unique to this specialty due to the complexity and severity of the illness and the disruption to a patient’s daily life and thus are an integral part of cancer treatment.
Cancer Patient Support Services Delivered by Physicians Include:
Patient counseling and education on treatment options.
Planning complex chemotherapy regimens for cancer treatment.
Treatment and management of frequent, severe side effects of chemotherapy.
In-person family counseling on treatment, pain management, transition to end-of-life care, and other issues.
Extended telephone calls, emails, and other outside-the-office communications with patients and their families about the side effects of treatment and the progress of the patients’ condition.
Consultation with other physicians on treatment options and the availability of clinical trials.
Coordination with radiation and surgical oncologists.
Documenting disability for insurance companies and support applications for family leave.
Cancer Patient Support Services Delivered by Nurses Include:
Preparing and administering chemotherapy treatments directly to patients.
Monitoring patients’ vital signs before, during, and after chemotherapy treatment and treating adverse events, including damage resulting from leakage of the drug into tissue, nausea and vomiting, fluid volume overload leading to shortness of breath, fever, and life-threatening events such as anaphylaxis.
Querying the patient about other medications being used.
Communicating with patients and families about the side effects that may occur during and after chemotherapy administration and pain management.
Communicating with patients and families about long-term follow up care.
Assisting the patient in his/her navigation of the health care system (i.e., coordinating radiation, surgical services, and other care).
Extensive discussions with the patient and family, in and out of the doctor’s office, about informed consent regarding chemotherapy, clinical trial participation, and other treatments.
Cancer Patient Support Services Delivered by Nurses and Other Non-physician Staff Include:
Psychosocial support such as:
Counseling patients on their activities of daily living
Support groups that meet in the physician’s office
Nutrition counseling
Grief counseling
Social work services such as:
Helping patients with health insurance
Filling and refilling prescriptions
Obtaining prosthetics (e.g. breast prostheses and wigs)
Arranging physical therapy
Arranging transportation to and from the office for treatment
Implementing hospice referrals
Other services such as:
Financial assistance
Genetic counseling
Risk assessment
Cancer Patient Services and the Medicare Modernization Act (MMA) of 2003:
The Medicare Modernization Act of 2003 or "the MMA" addressed the long-debated topic of reimbursement for cancer chemotherapy drugs and patient support services. The MMA reduces payments for chemotherapy drugs and increases payments for cancer care delivery services in a manner that preserves overall reimbursements in 2004. However, changes in the Medicare payment structure for cancer care beginning in 2005 could severely limit patient access to community-based cancer care. If Medicare payments for office-based cancer care are reduced significantly, oncologists will be unable to furnish chemotherapy drugs and essential patient support services in their offices and would instead refer patients to other treatment sites that may not be as convenient or comfortable or have the capacity to handle an influx of patients.
Contact Us:
For more information, contact ASCO’s Cancer Policy & Clinical Affairs Department at 703-299-1050 or visit www.asco.org/mma.
The American Society of Clinical Oncology (ASCO) is the world’s leading professional society of multidisciplinary physicians who treat people with cancer. For 40 years, ASCO has been the leading authoritative source for reliable information on cancer care issues and the leading advocate for quality treatment and services for cancer patients.
What is the Medicare Prescription Drug, Improvement, and Modernization Act (MMA) of 2003?
The Medicare Modernization Act of 2003 or "the MMA," signed into law in December 2003, is primarily intended to provide seniors and people living with disabilities with a prescription drug benefit. Included in the bill are provisions addressing payments for drugs and drug administration services that institute significant cuts to cancer care over the next 10 years. The impact of the legislation on cancer care appears to be more severe in 2005 and subsequent years than in 2004.
Does ASCO support Medicare reform?
ASCO supports the general aims of the restructuring enacted in the MMA. However, there are serious problems with specific provisions of the MMA that must be addressed to avoid disruptions in patient care. More than 800,000 people on Medicare are diagnosed with cancer each year, and Medicare reimbursement policy must be designed to assure that cancer patients’ access to quality care and services is preserved. ASCO continues to support restructuring Medicare reimbursement methods for cancer treatment to more closely align the reimbursement amounts with the actual costs involved.
How does the MMA affect cancer care in 2004?
The MMA addressed the long-debated topic of how Medicare pays for cancer care. The MMA reduces payments for chemotherapy drugs and increases payments for patient support services in a manner that preserves overall reimbursement in 2004. While not ideal, ASCO believes these changes will allow oncologists to continue to offer quality cancer care. However, changes in the Medicare payment structure for cancer care beginning in 2005 could severely limit patient access to community-based chemotherapy and related services.
How does MMA change Medicare cancer care reimbursement in 2005?
Effective January 1, 2005, it appears likely that the payment methodology for drugs (106 percent of the manufacturer’s average sales price) will result in payment amounts for many drugs that do not cover the oncology practices’ costs. The non-partisan Congressional Budget Office (CBO) estimates that cancer drug payments to medical professionals will fall by approximately $300 million in 2005.
In addition, Medicare reimbursements for the patient support services related to chemotherapy will be reduced by an estimated 20 percent from 2004 levels. These patient support services include the work of highly trained oncology nurses who administer chemotherapy, patient education, extensive patient and family counseling and psychosocial support, nutritional counseling, social work services, and specialized equipment to mix and administer the chemotherapy. These services and others are often not reimbursable through Medicare.
How will ASCO ensure access to quality cancer care under the MMA?
ASCO’s first priority is to ensure that people living with cancer have access to the highest quality cancer care, including comprehensive community-based care. ASCO does not know the MMA’s full impact at this time. Congress has mandated studies that will examine the effects of the MMA on cancer care, but unfortunately these studies will not be completed until 2006 at the earliest. ASCO advises that Congress and the Administration maintain total Medicare reimbursement for chemotherapy costs in 2005 and 2006 at 2004 levels. ASCO envisions this as an interim solution, to provide more time to answer important questions regarding the impact of the cuts and to maintain patient access to quality care. On behalf of the millions of Americans on Medicare who are dealing with cancer, ASCO is looking forward to working cooperatively with CMS, Congress, and others in the cancer community to ensure that vital cancer treatment and services are not interrupted.
Is the oncology community united in its stance on MMA?
Yes. For 40 years, ASCO’s 20,000 members have set the standard for patient care worldwide, and the organization leads the way to make high quality cancer care as affordable and accessible as possible. While ASCO believes that provisions in the MMA will limit patients’ access to quality cancer care, change to the Medicare payment structure can only be achieved through a cooperative, informed discussion of the issues. ASCO is actively working with all members of the cancer community, including patient advocates, to lead the way on MMA interim measures to ensure uninterrupted community cancer care for patients.
