Reimbursement Policies Can Influence the Setting and Cost of Chemotherapy

PEMD-92-28: Published: Jul 17, 1992. Publicly Released: Aug 17, 1992.

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Pursuant to a congressional request, GAO examined factors that influence where oncologists treat Medicare patients and the potential cost to the federal government of treatment in different settings.

GAO found that: (1) some oncologists have treated cancer patients in hospital inpatient and outpatient settings when, by clinical standards, these patients could have received treatment in the office; (2) oncologists interviewed consistently stated that their choice of treatment setting was influenced by whether they expected reimbursement to be adequate if they provided treatment in the office setting; and (3) treatment in the hospital inpatient setting was more expensive to Medicare than hospital outpatient or office treatment settings.