Johnstone Peter A S, Peneguy Susan, Showalter Timothy N, Yu James B
Department of Radiation Oncology, Moffitt Cancer Center & Research Institute, Tampa, FL, United States.
Department of Heath Outcomes & Behavior, Moffitt Cancer Center & Research Institute, Tampa, FL, United States.
Rep Pract Oncol Radiother. 2019 Mar-Apr;24(2):200-203. doi: 10.1016/j.rpor.2019.01.006. Epub 2019 Feb 20.
Describe the Value proposition for radiotherapy (RT) in the United States.
In the United States since 2005, two forces have worked to decrease RT cost per patient: Federal changes in reimbursement and hypofractionation of treatment courses. We theorize that these have driven stable reimbursement in the context of increasing technology of intensity modulation (IMRT) and image guidance (IGRT). This phenomenon provides increasing Value of the discipline to patients and systems.
We searched the Medicare Physician/Supplier data for Program Payments per Person with Utilization for 2000 through 2016. This involves two databases: Enrollment Database (EDB) for 2000-2012 and Common Medicare Enrollment (CME) since 2013. RT payments to individual patients accessing services were retrieved.
Taking into account the change of calculation algorithm used by CMS in 2013, costs per patient were similar in 2012 and 2003, and 2016 and 2013.
In the United States, stabilizing costs in the face of increasing work, better outcomes, and decreased toxicity contributes to increasing RT value over the past 10 years.
描述美国放射治疗（RT）的价值主张。
自2005年以来，在美国有两种力量致力于降低每位患者的放疗成本：联邦报销政策的变化和治疗疗程的大分割。我们推测，在调强放疗（IMRT）和图像引导放疗（IGRT）技术不断发展的背景下，这些因素推动了报销费用的稳定。这种现象为患者和医疗系统带来了该学科越来越高的价值。
我们在医疗保险医师/供应商数据中搜索了2000年至2016年按使用情况计算的人均项目支付费用。这涉及两个数据库：2000 - 2012年的参保数据库（EDB）和自2013年起的普通医疗保险参保数据库（CME）。检索了向接受服务的个体患者支付的放疗费用。
考虑到医疗保险和医疗补助服务中心（CMS）在2013年使用的计算算法的变化，2012年和2003年、2016年和2013年的每位患者成本相似。
在美国，在工作量增加、治疗效果改善和毒性降低的情况下保持成本稳定，有助于在过去10年中提高放疗的价值。
