Emory University officials have confidence in their own cancer-fighting facilities, and believe their insured employees can get “better quality and more cost-effective healthcare at their own cancer services” than through another for-profit competitor. In this context, just prior to the holidays, insured Emory University employees received a notice from the Human Resources Department that treatment at Cancer Treatment of America clinics would no longer be covered on Emory’s Medical Plan, beginning Jan. 1.
Those employees who are currently undergoing treatment in a CTCA clinic, which is expected to continue into 2016, will be eligible for benefits until the treatment is complete. According to an HR representative, this reimbursement will be paid at the out-of-network level.
Vince Dollard, associate vice president for communications at Emory’s Robert W. Woodruff Health Sciences, released the following statement when contacted Monday morning:
“Emory has taken this step in the best interests of our employees. After a thorough review of the available data, we have concluded that our insured employees can get better quality, more cost-effective care from Emory’s own cancer services, as well as other providers in Metro Atlanta and in Georgia.”
According to the notice sent to employees through a “News You Can Use” brief, Emory employees who chose to receive care at CTCA would not be covered or reimbursed through their healthcare plan. The notice also stated that “Emory Winshape Cancer Institute is Georgia’s first and only NCI-designated cancer center.” It also referenced the fact that cancer treatment for employees is available at four different Emory locations, as well as at Grady Hospital.
Monty Veazy, president of the Georgia Alliance of Community Hospitals, said he was not surprised at this decision by Emory officials.
“Emory has a world class cancer center which is NCI-designated, something CTCA is not,” said Veazy, whose organization represents about 80 not-for-profit hospitals across Georgia. “Actually, I was surprised that Emory actually allowed this to begin with.”
Veazy said his organization believes in competition “but on a level playing field.”
“CTCA offer no new services, do no research, they don’t accept Medicaid or indigent care, and they offer no emergency room services. The ER room is where most of our indigent and uninsured patients go. There have also been reports that when a patient’s insurance runs out, they send them somewhere else.”
According to their website, CTCA was founded in 1988 by Richard J Stephenson, in honor of his mother, who lost her battle with cancer in 1982. On June 18, 2009, CTCA announced that its fifth cancer treatment facility would be built in Newnan, off I-85 just south of Atlanta. Almost three years later, CTCA held its grand opening ceremonies. CTCA is also located in Chicago, Philadelphia, Phoenix and Tulsa.
CTCA’s arrival in Georgia came amid fierce opposition from not-for-profits hospitals across the state and state hospital associations. Proponents felt CTCA skirted the usual process for obtaining approval to build hospitals in Georgia. Veazy and his organization were among those opposing CTCA in Georgia.
A September 2015 Atlanta Journal Constitution article stated, “Georgia typically requires hospitals to go through a stringent “Certificate of Need” process that is intended to prevent an oversupply of healthcare facilities and to control costs. But in 2008 the General Assembly allowed Cancer Treatment Centers of America to open the Newnan facility without going through the process because it was touted as a destination hospital that would draw patients to Georgia. As such, lawmakers limited it to 50 beds and required that at least 65 percent of its patients come from out of state.”
