ASTRO Study: Rad Therapy Equipment Use Rates Well Below 90%

Actual utilization rates for radiation therapy equipment used in freestanding cancer treatment centers are closer to the current assumed rate of 50%, not 90%, as proposed by the Centers for Medicare & Medicaid Services (CMS) in the Medicare physician fee schedule proposed rule for 2010, according to a new survey by dmrkynetec that was commissioned by the American Society for Radiation Oncology (ASTRO).
 
“Our study … shows that Medicare’s proposed equipment utilization rate for freestanding radiation therapy centers is inappropriate for radiation therapy,” says Patricia Eifel, MD, FASTRO, chairman of ASTRO and a professor of radiation oncology at M.D. Anderson Cancer Center in Houston. “We are presenting this data to CMS this week and encouraging the agency to maintain the current rate of 50% for radiation therapy equipment.”
 
On July 13, 2009, CMS announced proposed changes to the Medicare policies and payment rates for physician services, including radiation oncology, that would cut radiation therapy by nearly 20%. Currently, CMS pays for radiation therapy services based on an equipment utilization rate of 50%. The utilization rate refers to the percentage of time that the cancer clinic is open and that the equipment, such as linear accelerators, is in use. Radiation therapy is due to receive extreme cuts due in part to CMS increasing the assumed utilization rate for equipment costing more than $1 million from 50% to 90%. By increasing the utilization rate, the payment for each service is reduced significantly. CMS did not reference any actual utilization rate data for radiation therapy equipment in proposing to increase the rate to 90%.
 
ASTRO, along with researchers at dmrkynetec, began a research project to create a database detailing the 2008 equipment utilization rates at freestanding cancer centers providing radiation therapy services. Data on the daily utilization rates was collected for six different treatment modality categories, depending upon the services and equipment used at each individual center. These treatment modalities included 3D conformal radiation therapy, intensity modulated radiation therapy, image-guided radiation therapy, stereotactic radiation therapy, brachytherapy, and hyperthermia. This study was designed to determine how many treatment modality categories (among the six most common) that each cancer clinic center is providing, determine what type of equipment each center is using, identify the number of pieces of equipment of each type that centers have available, and determine how many hours per day each piece of equipment is typically in use.
 
Interviews were conducted between July 7, 2009, and July 23, 2009. Completed questionnaires were obtained from centers in 29 states and covered all major geographic areas of the country. Primary targets for this study were center business managers, radiation oncologists, or other staff members with knowledge of the equipment and usage patterns at their center. The sample pool for the study consisted of 2,844 radiation oncologists provided by ASTRO. More than 100 questionnaires were used in this analysis.
 
“We are hopeful CMS will accept the findings of this independent research study and change its course regarding proposed cuts to radiation oncology,” says Eifel.
 
— Source: American Society for Radiation Oncology