Medicare Quality Cancer Care Demonstration Act

The United States Medicare Quality Cancer Care Demonstration Act of 2009 (H.R. 2872) is a landmark, national initiative intended to enhance the quality of cancer care, focused on seniors covered by Medicare (approximately 45% of cancer patients are Medicare beneficiaries), while also controlling costs. House bill H.R. 2872 was introduced by Congressman Artur Davis (D-AL) and cosponsored by Representatives Steve Israel (D-NY) and Mary Jo Kilroy (D-OH).

The Quality Cancer Care Demonstration (QCCD) project was developed by community oncologists, with input from policy experts, to be a national Medicare demonstration project focused on two key aspects of cancer care: treatment planning and end-of-life care. Treatment planning involves all of the essential components of establishing the cancer care plan and monitoring its effectiveness. End-of-life care involves all of the essential components of patient-centric cancer care relating to individuals facing end-of-life planning and decisions.

H.R. 2872 calls for national reporting, via the Medicare payment system, of key metrics of evidence based care, refinement of those metrics, and development of a new Medicare performance-based reimbursement system that is patient-centric and quality driven, while aligning better with parameters of cost control.

The bill includes the following elements:[1]

• Establish a national Medicare demonstration project implemented by the Centers for Medicare & Medicaid Services (CMS) and open to all oncology practices.
• Address current shortcomings in treatment planning and end-of-life care by improving metrics and aligning incentives relating to that care.
• Having oncologists to report (through the Medicare reimbursement system) quality measures concerning their treatment plans and end-of-life care. It would include refinement and improvement of those plans.
• Allocate $300 million per year in Medicare funding to revise the Medicare payment system. Those payments would be based on quality and cost-efficiency.
• Incorporate the key elements under discussion in the healthcare reform debate — quality care delivery, evidence-based medicine, care coordination, patient-centric, cost control, health information technology, and pay-for-performance — in producing an evolved payment system.
• Evaluation of QCCD to determine participation of oncologists and cost effectiveness of the plan.
• Conducting of the demonstration project over a period of not less than two years to allow for improvement of reporting, metrics, and analysis.
• A substantive project that can be implemented within 6 months by CMS and be available to all oncologists nationwide.
• Could serve as a model for other areas of specific care relating to terminal illness for Medicare beneficiaries.