Results from a survey released by the American Society for Radiation Oncology (ASTRO) indicate that further cuts to Medicare for radiation treatment would have a damaging impact on cancer care, increasing patient wait times and forcing clinics to cut staff or even close.
Almost 96% of the 675 U.S.-based radiation oncologists who responded to the online survey ASTRO conducted in April said that patient care would suffer from any further cuts to Medicare reimbursement for radiation therapy, and approximately 70% said that the effects would be significant.
In addition, 65% of respondents said further cuts would lead to downsizing of practices, including reducing staff (65% of respondents), and that further cuts would make it more difficult to hire and retain staff (86%). Another round of cuts would delay or deter upgrades and investments in treatment technologies, according to 87% of survey participants.
Almost two-thirds (63%) of all those who responded to the survey said an additional cut of 4% to 5% would severely affect their practice’s viability, while 32% said they would be moderately affected; 20% said a cut of 1% to 3% would still have a severe impact on their practice’s viability. For rural doctors, this percentage was 26%.
An additional 6% cut would lead to practice downsizing, according to 89% of respondents. At that 6% level, 51% said this could force them to close, consolidate, leave, or sell their practice.
Of note, 32% of the responding doctors practicing in rural areas and 38% of those at independent, freestanding centers said that another cut of 3% to 5% would force them to close, consolidate, leave, or sell their practice. These rural and independent doctors also predicted more significant reductions in patient access with any further Medicare cuts (68% overall).
More cuts would also lead to delays in treatment for patients, 65% said. This was especially anticipated among doctors at academic centers and in urban areas.
With the new survey underscoring the damage that further cuts in Medicare would do to radiation treatment, ASTRO noted in a statement that radiation oncologists are currently on Capitol Hill urging lawmakers to pass the bipartisan Radiation Oncology Case Rate (ROCR) Act before additional Medicare cuts are proposed. In moving from a volume-based system to a value-based, bundled-payment model, the ROCR Act would stabilize Medicare payments, protect patient access, and enhance cancer treatment outcomes, the organization said.
ASTRO added that reimbursement for radiation therapy under Medicare has decreased by 25% since 2013. The effects of these cuts are exacerbated by financial pressures from increased costs, less utilization, and the resulting practice consolidation, which in turn reduces both competition and patient access to cancer care, it said.
