Dr. Pecora on the Medicare Part B Drug Payment Model

Andrew L. Pecora, MD
Published: Friday, Aug 12, 2016


Andrew L. Pecora, MD, president of the Physician Services Division and chief innovation officer at Hackensack Meridian Health, discusses the Medicare Part B Drug Payment Model (OCM) and other aspects of healthcare reform.

The Medicare Part B drug demo has not engendered a warm reception from ASCO, the Community Oncology Alliance, and other groups. It has been described as a system that would increase the difficulty that physician practices already have paying for and providing drugs for their patients without going broke in the process.

Some in the public payer system believe that some physicians are incentivized under the current system to prescribe more expensive drugs because of the higher margins they can make. However, Pecora says that physicians find it offensive that people would suspect them of putting profits ahead of wise and frugal medical decisions.

It’s closer to reality that newer medications are both effective and costly, which makes them expensive to use but also vital for the practice of effective medicine; and Pecora explains that the slim payment margins physicians would receive under the Medicare Part B demo are not going to cut it—and wouldn’t cut it in the private world of business either. Government, he says, has made a wrong turn.

Andrew L. Pecora, MD, president of the Physician Services Division and chief innovation officer at Hackensack Meridian Health, discusses the Medicare Part B Drug Payment Model (OCM) and other aspects of healthcare reform.

The Medicare Part B drug demo has not engendered a warm reception from ASCO, the Community Oncology Alliance, and other groups. It has been described as a system that would increase the difficulty that physician practices already have paying for and providing drugs for their patients without going broke in the process.

Some in the public payer system believe that some physicians are incentivized under the current system to prescribe more expensive drugs because of the higher margins they can make. However, Pecora says that physicians find it offensive that people would suspect them of putting profits ahead of wise and frugal medical decisions.

It’s closer to reality that newer medications are both effective and costly, which makes them expensive to use but also vital for the practice of effective medicine; and Pecora explains that the slim payment margins physicians would receive under the Medicare Part B demo are not going to cut it—and wouldn’t cut it in the private world of business either. Government, he says, has made a wrong turn.

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