Sequestration Impact Survey:Round 3

ASCO continues to closely monitor the far-reaching effects of sequestration across oncology practice and research. Six months ago, we asked you about the initial impact of sequestration. Results showed that practices were working hard to provide care for Medicare patients, but 50 percent of respondents reported being forced to send patients to hospitals for chemotherapy. A smaller number were not able to see Medicare patients at all. This was just one month into the budget cuts; a follow-up survey in June showed very similar results.

In light of the recent budget developments, ASCO is redoubling its efforts to urge Congress to exempt Medicare Part B drugs from sequestration—but we need your help so that Congress will fully understand the impact of these cuts to you and your patients.

Please take a few moments to complete the following brief survey by no later than Monday, November 11. If you completed our sequestration impact surveys in the past, we need to hear from you again to ensure we have the most current picture of the effects of the funding cuts on oncology practice.

Thank you for participating in this critical endeavor.

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* 1. Have the cuts affected your practice?

Yes

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* 2. Please check all sequestration effects that apply (for Medicare FEE-FOR-SERVICE patients):

I have stopped taking new Medicare patients

I won't see Medicare patients without secondary insurance

My FFS patients no longer participate in clinical research

No effect

Other effects (please specify)

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* 3. Do you now send Medicare FFS patients elsewhere for chemotherapy?

Yes

If yes, where (e.g., hospital outpatient department, other institution)

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* 4. If "yes" to above, approximately what additional percentage of your Medicare FFS patients now receives chemotherapy elsewhere (compared to before the sequester)?

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* 5. Please check all that apply (for Medicare ADVANTAGE patients):

I have stopped taking new MA patients

My MA patients no longer participate in clinical research

No effect

Other effects (please specify)

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* 6. Do you now send Medicare Advantage patients elsewhere for chemotherapy?

Yes

If yes, where (e.g., hospital outpatient department, other institution)

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* 7. If "yes" to above, approximately what additional percentage of your Medicare Advantage patients now receives chemotherapy elsewhere (compared to before the sequester)?

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* 8. Have the sequester cuts impacted your decision to participate in federally sponsored clinical trials? Please choose one response from the following:

I have decided to limit the number of federally sponsored trials I open and/or patients I enroll in federally sponsored trials at my site

I have decided to end my participation in federally sponsored trials

I have decided to increase my participation in federally sponsored trials

Medicare cuts have NOT impacted my participation in federally sponsored trials

I do not currently participate in federally sponsored trials

If so, why?

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* 9. Please check all that apply to your practice since the start of the sequester on April 1, 2013:

I am having more difficulty paying for the costs of the drugs needed by my practice

I have already laid off clinical staff

I am planning to lay off clinical staff in the next three months

I have already laid off administrative/support staff

I am planning to lay off administrative/support staff in the next three months

I have already closed satellite clinics or outreach clinics

I am planning to close satellite or outreach clinics in the next three months

No effect

Other effects (please specify)

If there has been no effect, you can skip to question 16.

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* 10. Since the start of the sequester, if you have already laid off clinical staff, how many?

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* 11. If you are planning to lay off clinical staff in the next three months, how many?

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* 12. Since the start of the sequester, if you have laid off administrative/support staff, how many?

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* 13. If you are planning to lay off administrative/support staff in the next three months, how many?

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* 14. Since the start of the sequester, if you have already closed satellite clinics or outreach clinics, how many?

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* 15. If you will need to close satellite clinics or outreach clinics in the next three months, how many?

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* 16. Are you now white bagging or brown bagging some or all of your underwater drugs (If yes, please explain)?

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* 17. How many medical oncologists (full-time equivalents) are in your practice?

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* 18. Please estimate the number of new Medicare FFS patients you see in an average year:

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* 19. What percent is this of your entire patient population?

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* 20. Please estimate the number of new Medicare Advantage patients you see in an average year:

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* 21. What percent is this of your entire patient population?

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* 22. How would you characterize your practice?

Urban

Rural

Suburban

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* 23. How is your practice owned (i.e., who writes the checks)? (check one below)

Private community practice characterized as a corporation, partnership or other legal entity

Private ‘integrated’ group practice that is part of a large health care system (including those practices captured within closed health care systems, e.g., Mayo, Geisinger, Scott & White, Kaiser, etc.)

Institutional non-academic, employed physicians (including non-academic hospital, 501.a or 501.c3, or entities that are captured by part of the institution)

Institutional non-academic, contracted physicians

Academic practice (with academic teaching, academic research activities)

Academic, community-based practice

Government (Federal: PHS, Military, VA, etc. or State)

Other: (please specify)