Today let’s explore MSKCC and Dana Farber’s counterpoint to placing PPS-exemptions on the chopping block in order to meet oncology cost-savings goals. The argument is hospitals exclusively treating cancer require higher reimbursement for oncology services as they primarily treat Medicare populations and don’t have any non-cancer services such as orthopedics or cardiology to offset system-wide losses. The preferential reimbursement afforded by PPS-exemption is what leads to these centers serving as the pinnacles of oncology research. “Because of the participating centers' clinical and research output, any curtailment of the program would almost certainly adversely affect the quality of cancer care delivered to all Americans.” Due to current high-risk high-reward research (and aggressive advertising..?) budgets of these centers, discontinuing PPS-exemption would result in “Medicare operating losses far in excess of their peers.” Perhaps the most controversial insinuation made is that the current system of PPS-exemption results in longer lives for the patients receiving care at these world-class centers, as if no social determinants of care could be reflected in the ability to fly across the world for hand-selected treatments. Ultimately, they call for turning our attention from the “pittance” of PPS-exemption costs and turn to more sweeping reimbursement reforms that can increase everyone’s access to oncology services. | McBride & Bunnell, JCO Oncol Pract 2025
