Journal article
Quantitative evaluation of radiation oncologists' adaptability to lower reimbursing treatment programs
Practical Radiation Oncology, v 5(4), pp 267-273
01 Jul 2015
PMID: 25544552
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Purpose: Rapid development of sophisticated modalities has challenged radiation oncologists to evaluate work flow and care delivery processes. Our study assesses treatment modality use and willingness to alter management with anticipated limitations in reimbursement and resources.
Methods and materials: A web-based survey was sent to 43 radiation oncologists in a National Cancer Institute-designated comprehensive cancer center network. The survey contained 7 clinical cases with various acceptable treatment options based on our institutional clinical pathways. Each case was presented in 3 modules with varying situations: 1) unlimited resources with current reimbursement, (2) restricted reimbursement (bundled payment), and ( 3) both restricted reimbursement and resources. Reimbursement rates were based on the 2013 Medicare fee schedule. Adoption of lower reimbursing options (LROs) was defined as the percentage of scenarios in which a respondent selected an LRO compared with baseline.
Results: Forty-three physicians completed the survey, 11 (26%) at academic and 32 (74%) at community facilities. When bundled payment was imposed (module 1 vs 2), an increase in willingness to adopt LROs was observed (median 11.1%). When physicians were limited to both bundled payment and resource restriction, adoption of LROs was more pronounced (module 1 vs 3; median 22.2%, P <.01). There was a trend to selecting LROs between module 1 and 2 that reached significance when transitioning from module 1 to 3. A positive correlation between years in clinical practice and adoption of LROs was demonstrated (r(2) = 0.181, P <.01). This association remained significant when stratifying respondents by experience (<= 25 vs >25 years, P =.02).
Conclusions: Radiation oncologists were more likely to choose lower reimbursing treatment options when both resource restriction and bundled payment were presented. Those with fewer years of clinical practice were less inclined to alter management, perhaps reflecting modern residency training. Future cost-utility analyses may help to better guide radiation oncologists in selection of LROs. (C) 2015 American Society for Radiation Oncology. Published by Elsevier Inc. All rights reserved.
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Details
- Title
- Quantitative evaluation of radiation oncologists' adaptability to lower reimbursing treatment programs
- Creators
- Beant S. Gill - UPMC Hillman Cancer CenterSushil Beriwal - UPMC Hillman Cancer CenterMalolan S. Rajagopalan - UPMC Hillman Cancer CenterHong Wang - UPMC Hillman Cancer CenterKimberly Hodges - UPMC Hillman Cancer CenterJoel S. Greenberger - UPMC Hillman Cancer Center
- Publication Details
- Practical Radiation Oncology, v 5(4), pp 267-273
- Publisher
- Elsevier
- Number of pages
- 7
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Radiation Oncology (and Nuclear Medicine)
- Web of Science ID
- WOS:000422357700026
- Scopus ID
- 2-s2.0-84937162462
- Other Identifier
- 991021897289804721
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InCites Highlights
Data related to this publication, from InCites Benchmarking & Analytics tool:
- Web of Science research areas
- Oncology
- Radiology, Nuclear Medicine & Medical Imaging