PracticeNET Data Projects Full Impact of 2022 Medicare Reimbursement Proposals, Sequestration Cuts on Cancer Care

August 17, 2021

The American Society of Clinical Oncology and the Association for Clinical Oncology (collectively ASCO) released an in-depth analysis of the impact the 2022 Medicare Physician Fee Schedule (PFS) and Hospital Outpatient Prospective Payment System (OPPS) proposed rules—as well as pending sequestration cuts—could have on cancer care beginning January 1, 2022. The analysis was performed using a PracticeNET dataset of 35 physician and hospital-based practices in the United States.

ASCO’s modeling of the PFS proposal showed slightly larger reimbursement cuts, compared to Centers for Medicare & Medicaid Services (CMS) estimates, for both the hematology/oncology specialty (an ASCO-estimated 2.9% decrease vs. CMS-estimated 2% decrease) and for radiation oncology (an ASCO-estimated 6.4% cut vs. a CMS-estimated 5% cut). The difference between the ASCO and CMS estimates may be due to the higher proportion of private practices in the PracticeNET dataset.  

ASCO’s analysis also outlines the potential impact of the OPPS proposal on practices that participate in CMS’ Radiation Oncology Model, as well as the potential impact of the two Congressionally-mandated sequestrations that providers and practices are currently set to face in 2022. ASCO estimates that the cumulative impact of the PFS and OPPS proposals, plus the sequestrations, would reduce Medicare reimbursement for individual cancer practices between 3% and 14%, as compared to current rates.

Read the full analysis.

PracticeNET is an operational benchmarking program available to ASCO members and their practices. Fill out the participation form to join PracticeNET, or email the PracticeNET team with questions.

Bookmark ASCO in Action for updates about physician reimbursement, as well as news, advocacy, and analysis on cancer policy.