Click here to close now.

SYS-CON MEDIA Authors: Liz McMillan, Pat Romanski, Carmen Gonzalez, Kevin Jackson, Peter Silva

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
While DevOps most critically and famously fosters collaboration, communication, and integration through cultural change, culture is more of an output than an input. In order to actively drive cultural evolution, organizations must make substantial organizational and process changes, and adopt new technologies, to encourage a DevOps culture. Moderated by Andi Mann, panelists will discuss how to balance these three pillars of DevOps, where to focus attention (and resources), where organizations m...
“In the past year we've seen a lot of stabilization of WebRTC. You can now use it in production with a far greater degree of certainty. A lot of the real developments in the past year have been in things like the data channel, which will enable a whole new type of application," explained Peter Dunkley, Technical Director at Acision, in this SYS-CON.tv interview at @ThingsExpo, held Nov 4–6, 2014, at the Santa Clara Convention Center in Santa Clara, CA.
of cloud, colocation, managed services and disaster recovery solutions, will exhibit at SYS-CON's 16th International Cloud Expo®, which will take place on June 9-11, 2015, at the Javits Center in New York City, NY. TierPoint, LLC, is a leading national provider of information technology and data center services, including cloud, colocation, disaster recovery and managed IT services, with corporate headquarters in St. Louis, MO. TierPoint was formed through the strategic combination of some of t...
SYS-CON Events announced today that Column Technologies, a global technology solutions company, will exhibit at SYS-CON's DevOps Summit 2015 New York, which will take place June 9-11, 2015, at the Javits Center in New York City, NY. Established in 1998, Column Technologies is a leader in application performance and infrastructure management for commercial and federal markets. The company is headquartered in the United States, with a diverse and talented team of more than 350 employees around th...
SYS-CON Media announced today that @WebRTCSummit Blog, the largest WebRTC resource in the world, has been launched. @WebRTCSummit Blog offers top articles, news stories, and blog posts from the world's well-known experts and guarantees better exposure for its authors than any other publication. @WebRTCSummit Blog can be bookmarked ▸ Here @WebRTCSummit conference site can be bookmarked ▸ Here
Health care systems across the globe are under enormous strain, as facilities reach capacity and costs continue to rise. M2M and the Internet of Things have the potential to transform the industry through connected health solutions that can make care more efficient while reducing costs. In fact, Vodafone's annual M2M Barometer Report forecasts M2M applications rising to 57 percent in health care and life sciences by 2016. Lively is one of Vodafone's health care partners, whose solutions enable o...
SYS-CON Events announced today that Ciqada will exhibit at SYS-CON's @ThingsExpo, which will take place on June 9-11, 2015, at the Javits Center in New York City, NY. Ciqada™ makes it easy to connect your products to the Internet. By integrating key components - hardware, servers, dashboards, and mobile apps - into an easy-to-use, configurable system, your products can quickly and securely join the internet of things. With remote monitoring, control, and alert messaging capability, you will mee...
SYS-CON Events announced today that GENBAND, a leading developer of real time communications software solutions, has been named “Silver Sponsor” of SYS-CON's WebRTC Summit, which will take place on June 9-11, 2015, at the Javits Center in New York City, NY. The GENBAND team will be on hand to demonstrate their newest product, Kandy. Kandy is a communications Platform-as-a-Service (PaaS) that enables companies to seamlessly integrate more human communications into their Web and mobile applicatio...
Public Cloud IaaS started it's life in the developer and startup communities and has grown rapidly to a $20B+ industry, but it still pales in comparison to how much is spent worldwide on IT: $3.6 trillion. In fact, there are 8.6 million data centers worldwide, the reality is many small and medium sized business have server closets and colocation footprints filled with servers and storage gear. While on-premise environment virtualization may have peaked at 75%, the Public Cloud has lagged in ado...
Dave will share his insights on how Internet of Things for Enterprises are transforming and making more productive and efficient operations and maintenance (O&M) procedures in the cleantech industry and beyond. Speaker Bio: Dave Landa is chief operating officer of Cybozu Corp (kintone US). Based in the San Francisco Bay Area, Dave has been on the forefront of the Cloud revolution driving strategic business development on the executive teams of multiple leading Software as a Services (SaaS) ap...
The best mobile applications are augmented by dedicated servers, the Internet and Cloud services. Mobile developers should focus on one thing: writing the next socially disruptive viral app. Thanks to the cloud, they can focus on the overall solution, not the underlying plumbing. From iOS to Android and Windows, developers can leverage cloud services to create a common cross-platform backend to persist user settings, app data, broadcast notifications, run jobs, etc. This session provide...
SYS-CON Events announced today that BroadSoft, the leading global provider of Unified Communications and Collaboration (UCC) services to operators worldwide, has been named “Gold Sponsor” of SYS-CON's WebRTC Summit, which will take place on June 9-11, 2015, at the Javits Center in New York City, NY. BroadSoft is the leading provider of software and services that enable mobile, fixed-line and cable service providers to offer Unified Communications over their Internet Protocol networks. The Compa...
While not quite mainstream yet, WebRTC is starting to gain ground with Carriers, Enterprises and Independent Software Vendors (ISV’s) alike. WebRTC makes it easy for developers to add audio and video communications into their applications by using Web browsers as their platform. But like any market, every customer engagement has unique requirements, as well as constraints. And of course, one size does not fit all. In her session at WebRTC Summit, Dr. Natasha Tamaskar, Vice President, Head of C...
ProfitBricks, the provider of painless cloud infrastructure IaaS, today released its SDK for Ruby, written against the company's new RESTful API. The new SDK joins ProfitBricks' previously announced support for the popular multi-cloud open-source Fog project. This new Ruby SDK, which exposes advanced functionality to take advantage of ProfitBricks' simplicity and productivity, aligns with ProfitBricks' mission to provide a painless way to automate infrastructure in the cloud. Ruby is a genera...
The 5th International DevOps Summit, co-located with 17th International Cloud Expo – being held November 3-5, 2015, at the Santa Clara Convention Center in Santa Clara, CA – announces that its Call for Papers is open. Born out of proven success in agile development, cloud computing, and process automation, DevOps is a macro trend you cannot afford to miss. From showcase success stories from early adopters and web-scale businesses, DevOps is expanding to organizations of all sizes, including the...