AMA House of Delegates Approves ASCO-Backed Resolutions on Payment Reform Models, Treatment Switching Incentives

June 22, 2021

From June 11-16, delegates from the Association for Clinical Oncology (ASCO) participated in a Special Meeting of the American Medical Association’s (AMA) House of Delegates (HOD). The AMA HOD is the principal policy-making body of AMA and meets twice a year to discuss pressing issues and establish association policies. While the ongoing COVID-19 public health emergency required a cancellation of the in-person Annual Meeting, AMA’s Board of Directors called for a virtual, Special Meeting focused on priority items.   

The AMA HOD voted to approve two ASCO-backed resolutions during the Special Meeting:

  • Payment Reform Models: Though the Physician-Focused Payment Model Technical Advisory Committee (PTAC)—an advisory group to the Department of Health and Human Services (HHS)—has reviewed and assessed submitted, physician-focused oncology payment models (PFPMs), the Centers for Medicare & Medicaid Services’ (CMS) Innovation Center (CMMI) has not acted on PTAC’s recommendations. In response, ASCO introduced a resolution directing AMA to advocate for CMS to seek innovative payment and care delivery models, which are voluntary and tailored to the needs of local communities and different specialties. The resolution, which was approved by the HOD, also directs AMA to continue to advocate against mandatory CMMI demonstration projects.
  • Patient Financial Incentives for Treatment Switching: ASCO co-sponsored a resolution to establish new HOD policy opposing the practice of insurance companies providing financial incentives for patients to switch treatments. Recently, Cigna notified certain patients that they could be eligible for a $500 pre-paid medical debit card if they agreed to stop taking one medication and switch to a payer-preferred alternative medication. Other large, national insurers are considering similar initiatives. These initiatives jeopardize patients’ health, interfere with medical decision making, and will disproportionately affect patients of lower socio-economic status. The HOD-approved resolution also directs AMA to support legislation banning these types of patient financial incentives for switching treatments.

During the AMA HOD Special Meeting, ASCO led two meetings of the HOD's Cancer Caucus, which provides a forum to address oncology-specific issues that are either being discussed or should be discussed by the HOD.

ASCO currently has three delegates to the AMA HOD: Edward P. Balaban, DO, FACP, FASCO; Kristina L. Novick, MD; and Ray D. Page, DO, PhD, FACOI, FASCO. The society also has two alternate delegates to the HOD: Thomas A. Marsland, MD, FASCO and Steve Y. Lee, MD. ASCO’s Resident Fellow Section Delegate is Erin L. Schwab, MPH, BS, MD. Barbara McAneny, MD, FASCO also participates with the delegation.  

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