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Life Health > Long-Term Care Planning

Cancer doctors’ like-hate relationship with PPACA

By Allison Bell

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New Patient Protection and Affordable Care Act (PPACA) programs and requirements may be helping some patients with cancer, but they may be reducing access to care for others.

Mark Antonnaci of InCrowd Inc., a health care provider survey firm, has published data supporting that assessment in a summary of results from a recent online survey of 100 oncologists. The authors of the survey asked the cancer doctors who participated to talk about the effects of PPACA.

Drafters of PPACA hoped to expand all patients’ access to basic preventive care and health screenings; to provide a basic “beer” level of coverage for people with serious health problems; and to discourage excessive use of care by increasing out-of-pocket costs for middle-income patients and high-income patients.

Even before President Obama signed PPACA into law in 2010, health policymakers were talking about a need to increase patients’ out-of-pocket costs, to give them “more skin in the game.”

PPACA drafters also hoped to reduce the amount of U.S. health care spending going toward paperwork.

In the real world, PPACA may be helping get some Americans who need an oncologist into an oncologists’ office: 35 percent of the oncologists said they “strongly agree” or “somewhat agree” that, due to PPACA, “our patient volume has increased significantly since the beginning of 2014.”

Thirty-five percent of the oncologists agreed or strongly agreed with the proposition that a PPACA clinical trials coverage provision has been a significant boon for some people with cancer.

About 42 percent said they think increased access to primary care and preventive services may help reduce the incidence of some types of cancer.

But 72 percent agreed that PPACA has “resulted in considerably more paperwork and a greater regulatory burden for my practice.”

The oncologists also see “skin in the game” increasing to a level that is discouraging patients from getting what the oncologists believe to be medically necessary treatments: 67 percent said increasing cost-sharing requirements are forcing people with cancer to defer or avoid needed treatments.

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