LUGPA: Hospital IMRT expenditures are on the rise

An analysis of data from a recent Government Accountability Office (GAO) report explains why there is no health policy advantage to limiting where patients can choose to receive radiation oncology services for prostate cancer, according to the Large Urology Group Practice Association (LUGPA), which conducted the analysis.

The efforts of radiation oncologists and others supporting a repeal of the in-office ancillary services exception appeared to gain traction with the release of the GAO report, which showed that the use of intensity-modulated radiation therapy (IMRT) to treat prostate cancer by urology group practices increased at the end of the last decade, according to Deepak A. Kapoor, MD, LUGPA’s president. However, LUGPA’s analysis of the data “actually undermines the efforts of the historical monopoly specialists,” Dr. Kapoor said in an online article in The Hill.

The GAO report stated that, after 2007, “the rapid increase in prostate cancer–related IMRT services performed by self-referring groups coincided with declines in these services within hospital outpatient departments and among non-self-referring groups.”

Dr. Kapoor countered that the LUGPA analysis shows expenditures for prostate cancer-related IMRT are declining as well, but not in all settings.

“After 2007, despite the migration of patients away from hospitals to physicians’ offices, prostate cancer-related IMRT costs in physicians’ offices decreased by $28 million,” Dr. Kapoor wrote. “Simultaneously, although the number of services provided by hospitals declined substantially, hospital prostate IMRT expenditures increased by $8 million.”

The GAO report indicated that reimbursement rates for IMRT have been increasing for services performed in hospital outpatient departments, he noted, and declining for those performed in physicians’ offices.

“It makes no sense to close more affordable treatment sites in favor of more expensive ones,” Dr. Kapoor said.

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