Radiation costs vary among Medicare patients with cancer

August 11, 2015, University of California - San Diego

Cost of radiation therapy among Medicare patients varied most widely because of factors unrelated to a patient or that person's cancer, report University of California, San Diego School of Medicine researchers in the Journal of Oncology Practice.

Year of diagnosis, location of treatment, clinic type and individual radiation provider accounted for 44 to 61 percent of the variation in cost for patients with breast, lung and prostate cancer therapies, according to the study published August 11 online. Factors associated with the patient or patient's tumor accounted for less than 3 percent of the variation in the cost of .

"We found that variability in Medicare reimbursement for radiotherapy does not depend on individual characteristics of patients or their cancers," said James Murphy, MD, assistant professor at UC San Diego School of Medicine and radiation therapist at Moores Cancer Center at UC San Diego Health. "Rather, reimbursement was tied to the provider, geography and technology used to treat patients. This strongly suggests inefficiency within the current Medicare reimbursement framework for radiation therapy."

Up to two-thirds of patients with cancer receive radiation therapy. Researchers focused on breast, prostate and lung cancers because they represent the most common malignancies treated with radiotherapy.

The cost of radiation therapy was estimated from Medicare reimbursements for outpatient radiation treatment. The total cost of radiation therapy for the 55,288 patients in the study was estimated to be more than $831 million.

"Understanding why vary for radiation therapy helps policy makers evaluate the efficiency of the current fee-for-service Medicare reimbursement system. Such insights are likely to shape policy reforms in the near-future," said Anthony Paravati, MD, first author of the study.

The authors acknowledge that the study does not consider the relationship between cost of and quality of care, therefore higher cost radiation could lead to higher quality . The link between cost and quality of care represents a future research question the authors hope to answer.

Explore further: Proposed 2016 Medicare physician cuts threaten access to community-based radiation therapy

Related Stories

Proposed 2016 Medicare physician cuts threaten access to community-based radiation therapy

July 23, 2015
The American Society for Radiation Oncology (ASTRO) is concerned about proposed additional payment cuts to radiation therapy detailed in the Centers for Medicare and Medicaid Services' (CMS) proposed Medicare Physician Fee ...

Researchers develop first genetic test to predict tumor sensitivity to radiation therapy

July 23, 2015
Recent advances in the understanding of cancer have led to more personalized therapies, such as drugs that target particular proteins and tests that analyze gene expression patterns in tumors to predict a patient's response ...

Focus on treatment costs, value: Less radiation for elderly women with early breast cancer

September 16, 2014
In a healthcare climate where the costs of treatment are increasingly weighed against potential benefit, a Yale study has found that radiation oncologists are using fewer or less-aggressive radiation procedures on elderly ...

Patients with gastrointestinal tumors at higher risk of other cancers

May 1, 2015
Researchers at UC San Diego School of Medicine conducted the first population-based study that characterizes the association and temporal relationship between gastrointestinal stromal tumors (GIST) and other cancers. The ...

Proton therapy shown to be less costly than some alternative radiotherapy techniques

October 31, 2014
In terms of duration of treatment and cost, patients with early stage breast cancer may benefit from accelerated partial breast irradiation (APBI) with proton therapy versus whole breast irradiation (WBI), according to new ...

Use of costly breast cancer therapy strongly influenced by reimbursement policy

April 28, 2011
What Medicare would pay for and where a radiation oncologist practiced were two factors that strongly influenced the choice of intensity-modulated radiation therapy (IMRT) for treating breast cancer, according to an article ...

Recommended for you

Scientists discover how breast cancer hibernates: study

May 22, 2018
Scientists have identified the mechanism that allows breast cancer cells to lie dormant in other parts of the body only to reemerge years later with lethal force, according to a study published Tuesday.

Researcher: Big data, networks identify cell signaling pathways in lung cancer

May 22, 2018
A team of scientists led by University of Montana cell biologist Mark Grimes has identified networks inside lung cancer cells that will help understand this cancer and fight it with drug treatments.

Resetting the epigenetic balance for cancer therapy

May 22, 2018
Though mutations in a gene called MLL3 are common across many types of cancers, their relationship to the development of the disease has been unclear. Now, a Northwestern Medicine study has identified an epigenetic imbalance ...

Downward-facing mouse: Stretching reduces tumor growth in mouse model of breast cancer

May 22, 2018
Many cancer patients seek out gentle, movement-based stretching techniques such as yoga, tai chi and qigong, but does stretching have an effect on cancer? While many animal studies have attempted to quantify the effects of ...

Compound in citrus oil could reduce dry mouth in head, neck cancer patients

May 21, 2018
A compound found in citrus oils could help alleviate dry mouth caused by radiation therapy in head and neck cancer patients, according to a new study by researchers at the Stanford University School of Medicine.

Ice cream funds research showing new strategy against thyroid cancer

May 21, 2018
Anaplastic thyroid cancer is almost uniformly fatal, with an average lifespan of about 5 months after diagnosis. And standard treatment for the condition includes 7 weeks of radiation, often along with chemotherapy.

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.