The Alliance of Dedicated Cancer Centers (ADCC) exclusively  treat cancer and, as such, face unique economic challenges under the general Medicare payment system for hospitals. In recognition of those challenges, Congress in 1983 established specific rules governing Medicare payments to Dedicated Cancer Centers.

The prospective payment system (PPS), which Medicare generally utilizes to pay hospitals for their services, is not well designed to pay Dedicated Cancer Centers. PPS is based on the assumption that a hospital will provide treatments for a variety of illnesses, which is true for more than 4,500 hospitals, and that low payments for treatments such as cancer will be offset by other treatments and procedures with higher payment rates. But that’s not an option for Dedicated Cancer Centers, and Congress has long seen fit to exempt the Dedicated Cancer Centers from PPS.

Instead, Congress has approved payment adjustments under which Medicare pays Dedicated Cancer Centers at a higher rate for cancer treatments than it does for hospitals treating cancer along with a variety of other diseases. Even with the adjustments granted by Congress, the Dedicated Cancer Centers continue to experience financial losses in treating Medicare beneficiaries.

Relevant Media Statements:

  • On GAO Medicare Payment Report: The GAO report paints a highly distorted picture based on incomplete data and a flawed analysis. It also fails to consider the critically important issue of treatment outcomes as an indicator of effectiveness and efficiency with taxpayer dollars, and should not be used as the foundation for any policy changes.

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  • On Site Neutrality: The ADCC strongly opposes legislation that would equalize Medicare payment rates for cancer services between hospital outpatient departments and physician office settings in a budget-neutral manner.

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