Cancer Care - A Report on Healthcare Reform

According to the American Cancer Society, cancer iscompetitive advantage over radiation oncology
second to heart disease as the leading cause ofcenters that offer a full range of treatment for
death in the United States. Radiation therapy is givencancers. Patients are unaware of the financial
to over 65% of all cancer diagnoses. As seen in theincentives and the impact on care. ASTRO has called
data presented at many of our meetings, we haveupon Congress to strengthen the "Stark" law by
made great strides over the last decade withremoving radiation oncology from the "in-office
increased survival rates. Major advances in technologyancillary" exception list.
have also allowed us to minimize the side effectsMedicare Physician Fee Schedule
seen with treatment. These changes have broughtMajor overhauls are needed in the formula that is
radiation oncology to the forefront of cancer care,used to calculate physician payments. Every year,
yet it is still misunderstood by many lay people whatcongressional action is taken to "patch" the system
we do. Very often there is confusion that leads toto avoid significant reductions in reimbursement. In
the notion that we are "part" of radiology. As we are2010, we face a 21.5% cut in reimbursement while
aware, this is simply not the case.the cost of providing the care is increasing due to
Attendees were briefed by the ASTRO governmenttechnological advances, salaries and general inflation.
relation's staff on the issues facing our profession.The problem lies within the sustainable growth
There were many guest speakers from legislativeformula (SGR). This concept was to reduce
leaders to health care consultants. The three primarypayments as the number of services that are
issues we face today are self-referral, proposed cutsprovided grows. The flaw in this formula is that it
to the Medicare physician's fee schedule andincludes prescription drugs. ASTRO has called upon
increases in funding for cancer research.Congress to prevent the 21.5% cut scheduled for
Self-referral2010 and replace it with a positive payment update
The physician self-referral or "Stark" law was enactedand work towards a long-term solution to stabilize
to prohibit physicians from referring Medicare patientspayments.
for healthcare services when the physician has aCancer Research Funding
financial interest with the service provider. The intentFunding of research at the NCI is a priority in the war
was to assure that clinical decisions related to patientagainst cancer and saving lives. During the 1990's,
treatment were made without financialfunding to the NCI was increasing annually. However,
considerations, assuring patient access to high-qualityin the last eight years, funding has remained flat.
services and discouraging overutilization.During this time the cost of research has increased,
Unfortunately, a loophole was added to the law. Thethereby limiting what research is being done. While
"in-office ancillary services" exception (IOAE) waswe are grateful for the $10 billion that was included
intended to apply to services such as x-rays and labfor the NIH in the President's stimulus package, the
tests that required a quick turnaround to facilitatelack of continued investment in cancer research
medical care.leaves us further behind in conducting research and
Radiation oncology was added to that list. Oursaving lives. ASTRO has called upon Congress to
service is not ancillary to any other. As a result,double funding for cancer research, thus ending the
arrangements have been made, most notably in Newdeclining funding trends for the NCI.
York, whereby urologists have formed a group thatThis year's ASTRO Advocacy Day's success can only
has invested in linear accelerators and now are ablebe determined by the actual changes that take place
to diagnose and treat prostate cancer patients whilein the coming months. Meetings with the House and
capturing all the technical charges associated with theSenate members was positive, and they now have a
treatment. These business arrangements have thebetter understanding of the issues we face and the
financial incentive to "cherry-pick" cancer patients forimpact of the decisions over the coming months will
the most profitable treatments, giving them ahave on our practices and those we treat.