COA Unveils complete Blueprint for U.S. Health Care Reform
WASHINGTON, Feb. 5,2025 — the Community Oncology Alliance (COA) has released a groundbreaking report titled the COA Prescription for Health Care Reform,a detailed roadmap aimed at stabilizing the U.S. health care system, protecting patients, and restoring competition in care delivery. The report diagnoses the systemic challenges plaguing the nation’s health care infrastructure and offers actionable solutions for Congress to address these urgent issues.
“Our health care system has reached a critical tipping point as Americans pay more then ever for health care that is becoming increasingly out of reach. Consolidation, administrative burdens, and skyrocketing costs are hurting patients and providers alike,” said Debra Patt, MD, PhD, MBA, FASCO, president of COA and a practicing breast cancer specialist in Austin, Texas. “As stewards of our cancer care system,we feel it is our duty to provide Congress with a blueprint for meaningful reform that protects independent community medical practices and the millions of patients they care for.”
The COA Prescription for Health Care Reform is structured as a five-part plan,each focusing on a critical aspect of reform. From curbing consolidation to modernizing Medicare policies, the report provides a comprehensive framework to address inefficiencies, inequities, and rising costs.
Key Areas of Focus
Table of Contents
- Interview: Community Oncology Alliance’s Prescription for Health Care Reform
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- Q: What prompted the Community Oncology Alliance (COA) to release the COA Prescription for Health Care Reform?
- Q: What are the key systemic issues highlighted in the report?
- Q: What are the key recommendations from the report?
- Q: How does oncology serve as a lens for broader health care reform?
- Q: What is the urgency behind these reforms?
- Q: How does the COA support independent community oncology practices?
- Q: How can policymakers and stakeholders access the full report?
- Conclusion
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- Hospitals and Health System Consolidation
The report highlights the monopolistic practices of mega “nonprofit” hospital systems, which raise costs, reduce provider choice, and limit competition. Recommendations include implementing site-neutral payment policies, overhauling the 340B program, and restricting aggressive debt collection practices.
- Insurance and Pharmacy Benefit Manager (PBM) Consolidation and Market Dominance
Insurers and their affiliated PBMs are criticized for inflating costs and limiting access to care. The report calls for greater transparency in PBM operations, accountability for formulary practices, and protections against prior authorization (PA) delays.
- Fixing Physician Reimbursement and Workforce Shortages
Independent medical practices are struggling under outdated Medicare reimbursement models. Immediate reforms include halting Medicare Physician Fee Schedule (MPFS) cuts, aligning reimbursements with inflation, and expanding residency positions to address workforce shortages.
A Call to Action
The COA Prescription for Health Care Reform is more than a report—it’s a call to action for Congress to prioritize patients and ensure access to affordable, high-quality care. As the health care system faces unprecedented challenges, the COA’s blueprint offers a path forward to restore balance and fairness.
| Key Recommendations | Impact |
|————————–|————|
| Site-neutral payment policies | Ensure fairness in reimbursements |
| Overhaul of the 340B program | Benefit patients as intended |
| Transparency in PBM operations | Reduce costs and improve access |
| Halting MPFS cuts | Support independent practices |
The full report, available on the COA website, provides a detailed analysis of these issues and more. As the debate over health care reform continues, the COA Prescription for Health Care Reform serves as a vital resource for policymakers and stakeholders alike.
For more facts, visit the COA Prescription for Health Care Reform report.Community Oncology Alliance Unveils Prescription for Health care Reform to Address Systemic Challenges in Cancer Care
The Community Oncology alliance (COA) has released it’s COA Prescription for Health Care Reform, a comprehensive framework aimed at tackling systemic issues in the U.S. health care system, with a particular focus on oncology. Rooted in over two decades of advocacy for independent community oncology practices, the report highlights actionable legislative reforms to ensure patient access to affordable, high-quality cancer care while safeguarding the financial sustainability of the health care system.
The Urgency for Reform
The U.S. health care system is at a critical juncture. Rising drug costs, chronic shortages of generic sterile injectable (GSI) drugs, and inequitable Medicare payment structures are jeopardizing patient access to essential cancer therapies. According to Ted Okon, executive director of COA, “If Congress does not act soon to address unfettered consolidation and continues to allow these issues to go unchecked, we’ll see worse outcomes for patients, higher costs, and fewer choices.”
The COA Prescription for Health Care Reform provides a roadmap for congressional action during the 119th Congress and beyond, addressing universal challenges such as consolidation, workforce shortages, and escalating costs.
Key Recommendations
The report outlines several critical areas for reform:
- Ensuring Access to Oncology Therapies (Drugs):
- Address rising drug costs and chronic shortages of GSI drugs.
– stabilize pricing for biosimilars and technically fix the Inflation Reduction Act (IRA) to protect independent practices from financial harm due to Medicare price negotiations.
- Modernizing Structural CMS Medicare Policies:
– Overhaul Medicare’s fragmented payment system to balance reimbursements across hospitals and independent practices.
– Strengthen oversight of the Center for Medicare and Medicaid Innovation (CMMI) to ensure patient-centered care models and prevent administrative burdens.
Oncology as a Lens for Broader Reform
Oncology serves as a microcosm of the broader health care system,encompassing complex care delivery,diverse treatment modalities,and interactions with every aspect of health care. The COA Prescription for Health Care Reform draws on insights from oncologists, pharmacists, practice administrators, and other health care experts to address systemic issues that extend beyond cancer care.
A Call to Action
The report emphasizes the need for immediate congressional action to prevent further consolidation, which threatens patient outcomes and drives up costs. “the time for action is now!” said Okon.
About the Community Oncology Alliance
The Community Oncology Alliance (COA) is a nonprofit institution dedicated to advocating for community oncology practices and the patients they serve. As the only organization solely focused on community oncology, COA plays a pivotal role in ensuring that the majority of Americans with cancer receive quality, affordable, and accessible care.
Read the Full Report
For a detailed look at the COA Prescription for Health Care Reform, visit the full report.
| Key Focus Areas | Recommendations |
|———————-|———————|
| Access to Oncology Therapies | Address drug shortages, stabilize biosimilar pricing, fix IRA |
| Medicare Payment Reform | Modernize CMS policies, strengthen CMMI oversight |
| systemic Health Care Issues | Combat consolidation, reduce costs, improve access |
The COA Prescription for Health Care Reform is a timely and critical call to action for policymakers, health care providers, and stakeholders to prioritize patient-centered care and ensure the sustainability of the U.S. health care system.The community oncology Alliance (COA) is a non-profit organization dedicated to advocating for patients with cancer and their providers in the independent, community oncology setting. With over 6,500 providers at 950 community cancer clinics, COA plays a pivotal role in ensuring that the majority of Americans with cancer receive high-quality, accessible, and affordable care.Independent community oncology practices are at the forefront of delivering evidence-based, cutting-edge cancer care tailored to the needs of patients in their own communities. These practices emphasize quality and value, ensuring that patients receive the best possible treatment without compromising affordability.
To learn more about the impactful work of the Community oncology Alliance, visit their official website at www.communityoncology.org.
| Key Facts About COA |
|————————–|
| Mission | Advocating for independent community oncology patients and practices |
| Providers | over 6,500 providers |
| Clinics | 950 community cancer clinics |
| Focus | High-quality, affordable, and accessible cancer care |
The COA continues to set standards in cancer care, ensuring that patients receive the support and treatment they need close to home. Their commitment to community-based oncology underscores the importance of localized, patient-centered care in the fight against cancer.
Interview: Community Oncology Alliance’s Prescription for Health Care Reform
Q: What prompted the Community Oncology Alliance (COA) to release the COA Prescription for Health Care Reform?
A: The Community Oncology Alliance (COA) released the Prescription for Health Care Reform in response to the growing systemic challenges in the U.S. health care system,particularly in cancer care. Over the past two decades, COA has been a steadfast advocate for independent community oncology practices, and this report is a culmination of their efforts to address issues like rising drug costs, generic sterile injectable (GSI) drug shortages, and inequitable Medicare payment structures. The goal is to ensure patient access to affordable, high-quality care while maintaining the financial sustainability of the health care system.
Q: What are the key systemic issues highlighted in the report?
A: The report identifies several critical issues, including:
- Rising Drug Costs: The escalating prices of cancer therapies and chronic shortages of generic sterile injectable (GSI) drugs are major concerns.
- medicare Payment Inequities: The fragmented Medicare payment system disproportionately disadvantages independent practices compared to hospitals.
- consolidation: The unchecked consolidation of health care providers threatens patient outcomes, increases costs, and reduces choices.
Q: What are the key recommendations from the report?
A: The COA Prescription for Health Care Reform outlines actionable steps for policymakers, including:
- Ensuring Access to Oncology Therapies: Addressing drug shortages, stabilizing biosimilar pricing, and fixing the Inflation Reduction Act (IRA) to protect independent practices from financial harm due to Medicare price negotiations.
- Modernizing Medicare Policies: Overhauling the fragmented Medicare payment system and strengthening oversight of the Center for Medicare and Medicaid Innovation (CMMI) to reduce administrative burdens and ensure patient-centered care models.
- Addressing Systemic Health Care Issues: Combating consolidation, reducing costs, and improving access to care across the broader health care system.
Q: How does oncology serve as a lens for broader health care reform?
A: Oncology is a microcosm of the broader health care system, encompassing complex care delivery, diverse treatment modalities, and interactions with every aspect of health care. The challenges faced in cancer care—such as drug shortages, payment inequities, and consolidation—reflect systemic issues that affect the entire health care landscape. By addressing these challenges in oncology, the COA’s recommendations can serve as a blueprint for broader reform.
Q: What is the urgency behind these reforms?
A: The U.S. health care system is at a critical juncture. Without immediate action, the unchecked consolidation of providers and escalating costs will lead to worse patient outcomes, higher expenses, and fewer choices. As Ted Okon, executive director of COA, stated, “The time for action is now!” The report serves as a roadmap for Congressional action during the 119th Congress and beyond.
Q: How does the COA support independent community oncology practices?
A: The Community Oncology Alliance (COA) is the only organization solely focused on advocating for independent community oncology practices. With over 6,500 providers at 950 community cancer clinics, COA ensures that the majority of Americans with cancer receive high-quality, affordable, and accessible care. Their advocacy efforts emphasize the importance of localized, patient-centered care in the fight against cancer.
Q: How can policymakers and stakeholders access the full report?
A: The full COA Prescription for Health Care Reform report is available on the COA website. Policymakers, stakeholders, and the public can access the detailed analysis and recommendations by visiting the full report.
Conclusion
The COA Prescription for Health Care Reform is a timely and critical call to action for policymakers, health care providers, and stakeholders to prioritize patient-centered care and ensure the sustainability of the U.S. health care system. By addressing systemic issues like rising drug costs, Medicare payment inequities, and consolidation, the report provides a comprehensive framework for meaningful reform, with a particular focus on oncology. The COA’s advocacy for independent community oncology practices highlights the importance of localized, high-quality care in the ongoing fight against cancer.
