The first (annual) cut is the deepest.

Your inbox probably blew up late last week with the news of 2% proposed cuts to radiation oncology. We doubt you’re gonna read the proposal, or even the summaries. But we know you’re gonna read QuadShot, so we’re summarizing the summary (the ASTRO one to be specific). In brief, Medicare has a formula that determines how much they pay for care. It boils down to people, stuff, and risk. You modify each of those to account for geographic costs, add them up, and then multiply by a conversion factor to arrive at dollars and cents. Medicare is proposing some pretty big cuts to the “stuff” factor that includes practice expense (i.e., technical fees) for radiation oncology equipment. That cut mainly pertains to the linear accelerator costs for SBRT, but also includes things like the cost of the water chiller needed to keep the machines cool. Not cool. The other major cuts involve lumping clinic complexity levels 2 to 5 into a single reimbursement rate to help cut back on the documentation burden. That, or we could rethink the model of writing notes for a billing staff audience. TBL: Our advocacy bodies generally do a pretty good job of challenging counterproductive cuts, but it never hurts to add an extra voice. | ASTRO 2018