The Medicare Quality Cancer Care Demonstration Act of 2009 (H.R. 2872) was introduced in the House of Representatives on June 15, 2009 It was intended to be a landmark, national initiative that would enhance the quality of care for Medicare beneficiaries, which compose approximately 45% of all cancer patients. This was hope to be accomplished while also controlling costs. House bill H.R. 2872 was introduced by Congressman Artur Davis (D-AL). It was cosponsored by Representatives Mary Jo Kilroy (D-OH), Steve Israel (D-NY), Joe Courtney (D-CT) and Adam Schiff (D-CA). The Quality Cancer Care Demonstration (QCCD) project was drafted by community oncologists. There was also input from policy experts. The Bill did not pass the House of Representatives.
Treatment planning and end-of-life care were are the heart of the legislation. Treatment planning revolves around establishing a cancer care plan and monitoring the effect of the plan. End-of-life care involves patient-centered care for those faced with decisions pertaining a terminal cancer diagnosis, and how to manage care related to end-of-life.
The Medicare Quality Cancer Care Demonstration Act of 2009 included provisions for national reporting using the Medicare payment system, use of and refinement of key metrics revolving around evidence-based care, and developing a new reimbursement system that would assist in cost control while requiring quality care for cancer patients on Medicare.
The bill included the following elements:
- 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.