The authors write: "Contrary to concerns about access, we found that the changes actually increased the likelihood that
lung cancer patients received
chemotherapy. The type of
chemotherapy agents administered also changed. Physicians switched from dispensing the drugs that experienced the largest cuts in profitability ... We do not know what the effect was on
cancer patients, but these changes may have offset some of the savings projected from passage of the legislation. The ultimate message is that payment reforms have real consequences and should be undertaken with caution" (Jacobson et al., 6/17).