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Cancer clinic to drop 400 patients
Boulder doctor: Kaiser doesn't pay enough
By Marsha Austin

Article Published: Thursday, May 15, 2003 - 12:00:00 AM MST 

 Originally Posted at:,1413,36%257E33%257E1391476,00.html
Cancer clinic to drop 400 patients
Boulder doctor: Kaiser doesn't pay enough
By Marsha Austin, Denver Post Business Writer
Rocky Mountain Cancer Centers' Boulder clinic will drop 400 cancer patients who belong to the Kaiser Permanente health plan July 1.  
The clinic no longer can afford to care for the patients, most of whom are elderly, because Kaiser does not pay enough, clinic oncologist Dr. John Fleagle said.

While the Kaiser HMO members accounted for 25 percent of Rocky Mountain's patient visits last year, they generated only 7 percent of the clinic's revenue, Fleagle said.

The patients will have to travel to Denver to Kaiser clinics for care because the health plan has no other oncologist in the Boulder area. Rocky Mountain has 11 centers in Colorado but contracted with Kaiser to treat patients only in the Boulder area.

"It's a tremendous burden for our patients," Fleagle said. "It's a long drive in traffic and they are ill."

At the heart of the issue are chemotherapy drugs that oncologists buy from drug companies at a price significantly lower than the amount they are reimbursed by the government and health plans.

The money cancer doctors make from the drugs offsets professional fees that are far below the cost of caring for patients, Fleagle and other oncologists argue.

Kaiser insures more than 400,000 patients in Colorado and 8.4 million nationwide. It buys chemotherapy drugs in bulk at deep discounts and gives them to doctors at no charge, which eliminates the doctors' ability to mark up the medications, Kaiser Permanente of Colorado spokesman Steve Krizman said.

This keeps health costs down for members and is a policy the HMO was unwilling to bend for the Rocky Mountain Cancer Centers, and that ultimately soured the relationship.

"The doctors definitely wanted to get into the business of the drugs," said Krizman.

Fleagle says the doctors weren't trying to profit excessively from the Kaiser patients but were just asking for enough money to cover their costs.

"This is not about doctors' pay," he said. "They're (Kaiser) making record profits. We're just talking about surviving."

Kaiser made $42.4 million last year, more than any other Colorado HMO.

Seventy-six cancer patients are receiving chemotherapy and other treatments at Rocky Mountain's clinic in Boulder. Most of them are elderly and will have a difficult time traveling to Denver for care, Fleagle said.

"We are afraid that the patients just won't go to the doctor or will go to a physician's office that's not qualified to treat them," he said.

Krizman said Kaiser has hired two oncologists since January and may eventually send one to Boulder.

In the meantime, the health plan expects patients to be able to make the trip to Denver, he said. "Many of these patients don't need to come down here every day."

Rocky Mountain Oncology is hosting a meeting for patients affected by the change at 5 p.m. today at the Boulder clinic.

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