Cuts proposed to radiation oncology reimbursement by the U.S. Centers for Medicare and Medicaid Services (CMS) could have devastating effects on community cancer care, according to a survey conducted by the American Society for Radiation Oncology (ASTRO).
The Medicare Physician Fee Schedule that CMS released on July 6 proposes to significantly cut the reimbursement rate for radiation oncology services, beginning on January 1, 2013. These cuts represent a 15% reduction in overall payment, ASTRO said.
The most significant portion of the cuts, 7% overall, is due to a change in the treatment times for intensity-modulated radiation therapy (IMRT) and stereotactic body radiation therapy (SBRT), according to ASTRO. Instead of using the established process for valuing Medicare services, CMS relied on information from patient education materials to support the proposed new treatment times for IMRT and SBRT.
To back its position, ASTRO conduct a survey of its members to assess how they might respond to the proposed payment cuts. According to nearly 600 individual survey responses the society gathered in July, the cuts could severely affect community-based cancer care across the country:
- Access to care for Medicare patients could be limited: 70% of survey respondents reported they might have to limit treatment to Medicare patients, and 49% said they may be forced to no longer accept Medicare patients.
- Cancer centers may close: 35% of respondents in freestanding centers said they might close their practice, while 64% would have to consolidate practice locations, which would lead to longer travel times for patients getting daily treatments.
- Possible economic loss to communities: 53% of community-based practices might lay off physicians, and 81% of community-based practices might lay off professional staff such as nurses.
- Access to state-of-the-art technology could be affected: 93% could delay or cancel purchasing new, state-of-the-art technology, which would affect treatment options.
Members of Congress have also expressed concern about the proposed radiation oncology cuts. Reps. Joe Pitts (R-PA) and Frank Pallone (D-NJ), the respective chairman and ranking member of the House of Representatives Energy and Commerce Committee health subcommittee, as well as Rep. Mike Rogers (R-MI), are circulating a letter among their colleagues that will be sent to the administration. A similar bipartisan letter is being drafted in the Senate, ASTRO said.
