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
Evan Kirstel is an internationally recognized thought leader and social media influencer in IoT (#1 in 2017), Cloud, Data Security (2016), Health Tech (#9 in 2017), Digital Health (#6 in 2016), B2B Marketing (#5 in 2015), AI, Smart Home, Digital (2017), IIoT (#1 in 2017) and Telecom/Wireless/5G. His connections are a "Who's Who" in these technologies, He is in the top 10 most mentioned/re-tweeted by CMOs and CIOs (2016) and have been recently named 5th most influential B2B marketeer in the US. H...
The best way to leverage your Cloud Expo presence as a sponsor and exhibitor is to plan your news announcements around our events. The press covering Cloud Expo and @ThingsExpo will have access to these releases and will amplify your news announcements. More than two dozen Cloud companies either set deals at our shows or have announced their mergers and acquisitions at Cloud Expo. Product announcements during our show provide your company with the most reach through our targeted audiences.
DevOpsSummit New York 2018, colocated with CloudEXPO | DXWorldEXPO New York 2018 will be held November 11-13, 2018, in New York City. Digital Transformation (DX) is a major focus with the introduction of DXWorldEXPO within the program. Successful transformation requires a laser focus on being data-driven and on using all the tools available that enable transformation if they plan to survive over the long term. A total of 88% of Fortune 500 companies from a generation ago are now out of bus...
With 10 simultaneous tracks, keynotes, general sessions and targeted breakout classes, @CloudEXPO and DXWorldEXPO are two of the most important technology events of the year. Since its launch over eight years ago, @CloudEXPO and DXWorldEXPO have presented a rock star faculty as well as showcased hundreds of sponsors and exhibitors! In this blog post, we provide 7 tips on how, as part of our world-class faculty, you can deliver one of the most popular sessions at our events. But before reading...
DXWorldEXPO LLC announced today that "Miami Blockchain Event by FinTechEXPO" has announced that its Call for Papers is now open. The two-day event will present 20 top Blockchain experts. All speaking inquiries which covers the following information can be submitted by email to [email protected] Financial enterprises in New York City, London, Singapore, and other world financial capitals are embracing a new generation of smart, automated FinTech that eliminates many cumbersome, slow, and expe...
DXWordEXPO New York 2018, colocated with CloudEXPO New York 2018 will be held November 11-13, 2018, in New York City and will bring together Cloud Computing, FinTech and Blockchain, Digital Transformation, Big Data, Internet of Things, DevOps, AI, Machine Learning and WebRTC to one location.
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: implemen...
DXWorldEXPO LLC announced today that ICOHOLDER named "Media Sponsor" of Miami Blockchain Event by FinTechEXPO. ICOHOLDER give you detailed information and help the community to invest in the trusty projects. Miami Blockchain Event by FinTechEXPO has opened its Call for Papers. The two-day event will present 20 top Blockchain experts. All speaking inquiries which covers the following information can be submitted by email to [email protected] Miami Blockchain Event by FinTechEXPO also offers s...
DXWorldEXPO | CloudEXPO are the world's most influential, independent events where Cloud Computing was coined and where technology buyers and vendors meet to experience and discuss the big picture of Digital Transformation and all of the strategies, tactics, and tools they need to realize their goals. Sponsors of DXWorldEXPO | CloudEXPO benefit from unmatched branding, profile building and lead generation opportunities.
@DevOpsSummit New York 2018, colocated with CloudEXPO | DXWorldEXPO New York 2018 will be held November 11-13, 2018, in New York City. From showcase success stories from early adopters and web-scale businesses, DevOps is expanding to organizations of all sizes, including the world's largest enterprises - and delivering real results.
With tough new regulations coming to Europe on data privacy in May 2018, Calligo will explain why in reality the effect is global and transforms how you consider critical data. EU GDPR fundamentally rewrites the rules for cloud, Big Data and IoT. In his session at 21st Cloud Expo, Adam Ryan, Vice President and General Manager EMEA at Calligo, examined the regulations and provided insight on how it affects technology, challenges the established rules and will usher in new levels of diligence arou...
Dion Hinchcliffe is an internationally recognized digital expert, bestselling book author, frequent keynote speaker, analyst, futurist, and transformation expert based in Washington, DC. He is currently Chief Strategy Officer at the industry-leading digital strategy and online community solutions firm, 7Summits.
"We started a Master of Science in business analytics - that's the hot topic. We serve the business community around San Francisco so we educate the working professionals and this is where they all want to be," explained Judy Lee, Associate Professor and Department Chair at Golden Gate University, in this SYS-CON.tv interview at 21st Cloud Expo, held Oct 31 – Nov 2, 2017, at the Santa Clara Convention Center in Santa Clara, CA.
DXWorldEXPO LLC announced today that Dez Blanchfield joined the faculty of CloudEXPO's "10-Year Anniversary Event" which will take place on November 11-13, 2018 in New York City. Dez is a strategic leader in business and digital transformation with 25 years of experience in the IT and telecommunications industries developing strategies and implementing business initiatives. He has a breadth of expertise spanning technologies such as cloud computing, big data and analytics, cognitive computing, m...
Digital Transformation and Disruption, Amazon Style - What You Can Learn. Chris Kocher is a co-founder of Grey Heron, a management and strategic marketing consulting firm. He has 25+ years in both strategic and hands-on operating experience helping executives and investors build revenues and shareholder value. He has consulted with over 130 companies on innovating with new business models, product strategies and monetization. Chris has held management positions at HP and Symantec in addition to ...