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:

• Establishes a national Medicare demonstration project to be implemented by the Centers for Medicare & Medicaid Services (CMS) open to all oncology practices.
• Designed to address current shortcomings in quality metrics and aligned incentives in the areas of treatment planning and end-of-life care.
• Involves the reporting by oncologists, via the Medicare reimbursement system, of performance quality measures relating to treatment planning and end-of-life care and the refinement of those measures.
• Allocates $300 million per year in Medicare funding to produce a revised payment system based on quality and cost-efficiency in a true pay-for-performance model.
• Incorporates 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.
• Action-oriented and not another concept — substantive, developed project that can be implemented within 6 months by CMS open to all oncology practices nationwide.
• Can serve as a model for other areas of medical care.