ArticleBMJ (Clinical research ed.)2025
Provider billing margin and cancer treatment selection: population based cohort study.
Article in BMJ (Clinical research ed.), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
What it found
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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.
The trial behind it
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Who cites it
2 citing papers in PubMed.
- Quality, Cost, and Timeliness of Cancer Treatment in Medicare Advantage and Traditional Medicare.JAMA internal medicine · 2026Article
- How often do oncologists receive industry payments from competing companies?The oncologist · 2026Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
16 authors.
Funding
Abstract
objectiveTo estimate the association between the billing (profit) margin and clinical benefit of cancer treatments and use by oncologists.
designRetrospective population based cohort study
settingPopulation based sample using fee-for-service Medicare claims data.
participantsMedicare beneficiaries with an incident cancer diagnosis from 2015 to 2020; included all patients with cancer treatment indications for which the available treatment options varied in clinical benefit and billing margin. MAIN OUTCOMES AND MEASURES: The primary outcome was the cancer treatment each patient received among treatment options recommended by the National Comprehensive Cancer Network (NCCN). The characteristics of interest were provider billing margin (defined at the patient treatment level, using Medicare reimbursement rates corresponding to the patient's diagnosis date) and a proxy measure of clinical benefit (rank order of treatments based on Evidence Blocks scores developed by the NCCN, corresponding to the patient's diagnosis date). The association between treatment received, billing margin, and clinical benefit was modeled using a conditional logit model with inverse probability-of-treatment weights applied at the patient treatment level to control for patient and provider characteristics.
resultsTwelve cancer indications were examined comprising 19 397 individual patients. Provider billing margin ranged from $0 to $12 692 (£9440; €10 800) for each course of treatment. No association was found between a $100 increase in provider billing margin and the likelihood of treatment use (odds ratio 0.97, 95% confidence interval 0.91 to 1.03). Higher clinical benefit was associated with greater treatment use (1.62, 1.15 to 2.29).
conclusionsIn this observational study of Medicare beneficiaries, selection of cancer treatments was associated with the treatment's clinical benefit but not billing margin. Therefore, it is unlikely that policy and price changes that affect the billing margin of cancer treatments would shift patterns of use.
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