Evidence map›Paper›PMID 40190872›Full record

ArticleCureus2025

A Threat to Quality Cancer Care, Accessibility, and Sustainability: Medicare Payment Policies and Changing Utilization Patterns in Radiation Oncology.

Kishan M Patel, Tarita Thomas, Dwight E Heron, Constantine A Mantz

Abstract read
In one paragraph

Article in Cureus, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Article
  2. Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors.

Kishan M PatelDepartment of Radiation Oncology, Northwestern University Feinberg School of Medicine, Chicago, USA.
Tarita ThomasDepartment of Radiation Oncology, Northwestern University Feinberg School of Medicine, Chicago, USA.
Dwight E HeronDepartment of Radiation Oncology, Bon Secours Mercy Health System, Youngstown, USA.
Constantine A MantzDepartment of Radiation Oncology, GenesisCare US, Fort Meyers, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionRadiation oncology (RO) has undergone dramatic changes in clinical practice and reimbursement policy due to changes in the Medicare payment system, technological innovation in treatment modalities, and changing use patterns. This study aims to analyze the financial impact of these changes between 2016 and 2022 and their implications for the sustainability of practice and patient access.  Methods: We reviewed Medicare beneficiary-level claims data from 2016 and 2022 to determine trends in payment under the Medicare Physician Fee Schedule (MPFS) and Outpatient Prospective Payment System (OPPS). Treatment episodes were classified by modality (external beam radiation therapy (EBRT) and stereotactic body radiation therapy (SBRT)) and cancer type, with financial effects determined by payment policy changes, utilization changes, and conversion factor changes.  Results: The effect of payment policy changes was stable in relative value units (RVUs) and relative weights (RWs) with no combination of cancer type, service type, and practice setting, showing a difference of more than + 8% or -4%. Reimbursement for technical services in free-standing office practices declined by -16.9% for breast cancer and -14.2% for prostate cancer by greater use of hypofractionation. Inflation-adjusted Medicare conversion factors fell 12.2% in hospital outpatient departments and 20.8% in free-standing offices. The aggregate overall effects were favorable due to the geographic adjustment of national payment rates. For breast episodes, the impact sum for technical charges in the hospital outpatient setting was -21.8%, and the overall impact was -15.6%.  Conclusion: RO practices from 2016 to 2022 showed stable RVUs and RWs, indicating minimal changes to payment policy. However, due to transitioning to hypofractionated regimens and lower treatment volumes, reimbursement rates for technical services for breast and prostate cancers significantly declined. Geographic adjustments reduced overall impacts. However, specific policy initiatives are necessary to guarantee fair reimbursement and maintain access to quality cancer treatment.

Indexed as

conversion factormedicare physician fee scheduleoutpatient prospective payment systemradiation oncologyreimbursementrelative value unitsrelative weightsvalue-based care

Identifiers

PMID40190872
PMCPMC11969055

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.