Welcome!

News Feed Item

Public Release of Medicare Data Creates More Confusion about the Economics of Freestanding Radiation Therapy Centers, Highlights Need for Payment Reform

- CMS physician payment data do not properly reflect differences in overhead costs for freestanding radiation therapy or differences in site of service costs -

WASHINGTON, April 10, 2014 /PRNewswire-USNewswire/ -- The Radiation Therapy Alliance (RTA) – a non-profit organization representing leading freestanding radiation therapy centers and equipment manufacturers – today expressed concern that physician payment data released by the Centers for Medicare and Medicaid Services (CMS) fundamentally misrepresent the true economics of freestanding radiation oncology.

The RTA's primary concerns with the CMS physician payment data are as follows:

CMS' data do not properly represent the costs associated with quality cancer care.
Radiation therapy care uses targeted radiation to kill cancer cells with linear accelerators and lead-lined vaults to contain the radiation.  A separate CMS database shows this equipment costs on average more than $3.5 million.  However, Medicare payment data released yesterday for freestanding radiation oncologists combine payments to physicians for their work and payment to their practices for the purchase of this costly equipment necessary to save the lives of cancer patients.  In addition, the cost of services by physicists, dosimetrists, radiation therapists, and others under a radiation oncologist's supervision are included in the CMS data released for freestanding radiation oncologists.  All of these costs are paid independently to hospitals in the case of care provided by a hospital-based radiation oncologist.  Interpretations that the CMS data reflect profits to freestanding radiation oncologists, rather than reimbursement for the purchase of costly equipment and extensive clinical support personnel, is wildly misleading and do not reflect differences in overhead costs for doctors.

A notable exception to many press accounts on the Medicare data release was found in yesterday's Wall Street Journal article, which states, "The figures also don't reflect differences in overhead costs for doctors. While radiation oncology produces among the largest per-doctor payments of any specialty, only about 18% of those payments represent physician work, a smaller share than in other specialties. The remainder was meant to cover the doctors' overhead."[1]

CMS' data do not properly compare hospital and freestanding radiation oncology payments.
As CMS notes but few media reports explain there are additional payments to hospitals not captured in this data. They report, "For services delivered in a [hospital] facility… the data … represents the physician's professional fee and does not include the facility payment. On the other hand, for services delivered in a non-facility setting, such as a physician's office… the [data]… represents the complete payment for the service."  When accounting for all payments, including the purchase of radiation therapy equipment and payments to clinical support personnel, total costs to Medicare for radiation oncology care are typically higher for services performed in a hospital than for the same services in the freestanding setting.  Independent analyses by Avalere Health show hospital-based providers are reimbursed 10 percent more than freestanding providers for the same service

CMS' data exclude data on quality measures.
The data released by CMS yesterday focus solely on payment.  Without proper diagnosis, staging, quality metrics and patient outcome data, the value of services related to costs cannot be determined.

CMS' data exclude other important data.
The data released by CMS do not reflect differences in patient mix, local coverage policies and other factors.  Also, total payments to physicians will vary significantly based on total patients served.

CMS' data misrepresent other similarly situated specialties.
The CMS data are misleading for other specialties as well.  The data for hematologists/medical oncologists and ophthalmologists include payments for pharmaceuticals and for cardiologists include medical equipment and supply costs. The amounts indicated are not physician compensation, rather they are collections that have to cover facility costs, equipment costs, drugs, and clinical staff. 

"At the RTA, we have always supported, and will continue to support, transparency in the delivery of radiation therapy services, whether in quality outcomes or reimbursements rates.  Unfortunately, the recently released Medicare payment information has been presented in a way that is incredibly misleading, as already evidenced by much of the reporting we have seen on the issue," stated RTA spokesperson Dr. Chris Rose, Chief Technology Officer of Vantage Oncology.  "The fact is that Medicare reimbursement for freestanding radiation oncology providers has been reduced by nearly 19 percent over the last decade."

The RTA is continuing to work with Congress and CMS on policies that will provide payment stability for freestanding radiation oncology and replace the fee-for-service payment structure with an episode-based, bundled payment system.  Such an initiative will provide proper incentives for quality care and offer the payment stability necessary to improve outcomes and control costs.

About the Radiation Therapy Alliance

The RTA represents 244 community-based cancer care facilities in 22 states caring for approximately 98,000 patients annually. The RTA was established to provide policymakers and the public with a greater understanding of the value that community-based radiation therapy facilities bring to their patients and of the importance of logical, predictable payment reform to align incentives and ensure patient access to quality cancer care.

[1] Wall Street Journal, "Doctor-Pay Trove Shows Limits of Medicare Billing Data: Figures Don't Capture Complexity of Some Medical Practices," 9 April 2014

SOURCE Radiation Therapy Alliance

More Stories By PR Newswire

Copyright © 2007 PR Newswire. All rights reserved. Republication or redistribution of PRNewswire content is expressly prohibited without the prior written consent of PRNewswire. PRNewswire shall not be liable for any errors or delays in the content, or for any actions taken in reliance thereon.

Latest Stories
SYS-CON Events announced today that Ryobi Systems will exhibit at the Japan External Trade Organization (JETRO) Pavilion at SYS-CON's 21st International Cloud Expo®, which will take place on Oct 31 – Nov 2, 2017, at the Santa Clara Convention Center in Santa Clara, CA. Ryobi Systems Co., Ltd., as an information service company, specialized in business support for local governments and medical industry. We are challenging to achive the precision farming with AI. For more information, visit http:...
Amazon is pursuing new markets and disrupting industries at an incredible pace. Almost every industry seems to be in its crosshairs. Companies and industries that once thought they were safe are now worried about being “Amazoned.”. The new watch word should be “Be afraid. Be very afraid.” In his session 21st Cloud Expo, Chris Kocher, a co-founder of Grey Heron, will address questions such as: What new areas is Amazon disrupting? How are they doing this? Where are they likely to go? What are th...
As you move to the cloud, your network should be efficient, secure, and easy to manage. An enterprise adopting a hybrid or public cloud needs systems and tools that provide: Agility: ability to deliver applications and services faster, even in complex hybrid environments Easier manageability: enable reliable connectivity with complete oversight as the data center network evolves Greater efficiency: eliminate wasted effort while reducing errors and optimize asset utilization Security: imple...
High-velocity engineering teams are applying not only continuous delivery processes, but also lessons in experimentation from established leaders like Amazon, Netflix, and Facebook. These companies have made experimentation a foundation for their release processes, allowing them to try out major feature releases and redesigns within smaller groups before making them broadly available. In his session at 21st Cloud Expo, Brian Lucas, Senior Staff Engineer at Optimizely, will discuss how by using...
The next XaaS is CICDaaS. Why? Because CICD saves developers a huge amount of time. CD is an especially great option for projects that require multiple and frequent contributions to be integrated. But… securing CICD best practices is an emerging, essential, yet little understood practice for DevOps teams and their Cloud Service Providers. The only way to get CICD to work in a highly secure environment takes collaboration, patience and persistence. Building CICD in the cloud requires rigorous ar...
In this strange new world where more and more power is drawn from business technology, companies are effectively straddling two paths on the road to innovation and transformation into digital enterprises. The first path is the heritage trail – with “legacy” technology forming the background. Here, extant technologies are transformed by core IT teams to provide more API-driven approaches. Legacy systems can restrict companies that are transitioning into digital enterprises. To truly become a lead...
Companies are harnessing data in ways we once associated with science fiction. Analysts have access to a plethora of visualization and reporting tools, but considering the vast amount of data businesses collect and limitations of CPUs, end users are forced to design their structures and systems with limitations. Until now. As the cloud toolkit to analyze data has evolved, GPUs have stepped in to massively parallel SQL, visualization and machine learning.
DevOps at Cloud Expo, taking place October 31 - November 2, 2017, at the Santa Clara Convention Center in Santa Clara, CA, is co-located with 21st Cloud Expo and will feature technical sessions from a rock star conference faculty and the leading industry players in the world. The widespread success of cloud computing is driving the DevOps revolution in enterprise IT. Now as never before, development teams must communicate and collaborate in a dynamic, 24/7/365 environment. There is no time to w...
SYS-CON Events announced today that Daiya Industry will exhibit at the Japanese Pavilion at SYS-CON's 21st International Cloud Expo®, which will take place on Oct 31 – Nov 2, 2017, at the Santa Clara Convention Center in Santa Clara, CA. Ruby Development Inc. builds new services in short period of time and provides a continuous support of those services based on Ruby on Rails. For more information, please visit https://github.com/RubyDevInc.
When it comes to cloud computing, the ability to turn massive amounts of compute cores on and off on demand sounds attractive to IT staff, who need to manage peaks and valleys in user activity. With cloud bursting, the majority of the data can stay on premises while tapping into compute from public cloud providers, reducing risk and minimizing need to move large files. In his session at 18th Cloud Expo, Scott Jeschonek, Director of Product Management at Avere Systems, discussed the IT and busine...
As businesses evolve, they need technology that is simple to help them succeed today and flexible enough to help them build for tomorrow. Chrome is fit for the workplace of the future — providing a secure, consistent user experience across a range of devices that can be used anywhere. In her session at 21st Cloud Expo, Vidya Nagarajan, a Senior Product Manager at Google, will take a look at various options as to how ChromeOS can be leveraged to interact with people on the devices, and formats th...
First generation hyperconverged solutions have taken the data center by storm, rapidly proliferating in pockets everywhere to provide further consolidation of floor space and workloads. These first generation solutions are not without challenges, however. In his session at 21st Cloud Expo, Wes Talbert, a Principal Architect and results-driven enterprise sales leader at NetApp, will discuss how the HCI solution of tomorrow will integrate with the public cloud to deliver a quality hybrid cloud e...
Is advanced scheduling in Kubernetes achievable? Yes, however, how do you properly accommodate every real-life scenario that a Kubernetes user might encounter? How do you leverage advanced scheduling techniques to shape and describe each scenario in easy-to-use rules and configurations? In his session at @DevOpsSummit at 21st Cloud Expo, Oleg Chunikhin, CTO at Kublr, will answer these questions and demonstrate techniques for implementing advanced scheduling. For example, using spot instances ...
SYS-CON Events announced today that Yuasa System will exhibit at the Japan External Trade Organization (JETRO) Pavilion at SYS-CON's 21st International Cloud Expo®, which will take place on Oct 31 – Nov 2, 2017, at the Santa Clara Convention Center in Santa Clara, CA. Yuasa System is introducing a multi-purpose endurance testing system for flexible displays, OLED devices, flexible substrates, flat cables, and films in smartphones, wearables, automobiles, and healthcare.
SYS-CON Events announced today that Taica will exhibit at the Japan External Trade Organization (JETRO) Pavilion at SYS-CON's 21st International Cloud Expo®, which will take place on Oct 31 – Nov 2, 2017, at the Santa Clara Convention Center in Santa Clara, CA. Taica manufacturers Alpha-GEL brand silicone components and materials, which maintain outstanding performance over a wide temperature range -40C to +200C. For more information, visit http://www.taica.co.jp/english/.