Dr Shalom Kalnicki Discusses Bringing Value-Based Care to Radiation Oncology

The cost of radiation oncology services has typically been a small part of the Medicare and Medicaid budget, but with more patients having complex radiation treatments, it is becoming more important to have alternative payment models in the space, said Shalom Kalnicki, MD, FASTRO, FACRO, professor and chairman, radiation oncology, Montefiore Einstein Center for Cancer Care and Albert Einstein College of Medicine.

Transcript

How have radiation oncologists largely been left out of the value-based care movement before now?

It is interesting to see how the value-based movement has come sort of late to the radiation oncology space. One interesting fact is, I believe that push for that is because in the last decade or so, when alternative payment and value-based payment models became more popular, the cost in medical oncology and drug therapy have escalated at a much higher pace than the cost of radiation oncology.

There is data that shows that approximately 3 years or 4 years ago the total cost of Medicare and Medicaid for all radiation oncology services were equal too less than 20% of the total cost just for the drugs infused in the medical oncology space. So, I think that radiation oncology came late because of the smaller size of the budget.

However, the number of patients who are having complex radiation treatments, as opposed to surgery, for certain conditions like early-stage lung cancer, brain tumors, and others, where new techniques are more and more utilized, then these are obviously the single items that are the most expensive ones, needs to be taken into account and puts radiation oncology now after medical oncology as the number 2 item in cancer care to look at.

The data I know is that surgery accounts for less than 10% of the total cost when over 85% is accounted by medical and radiation oncology and about 5% imaging. So, I believe that’s the order the regulatory system will look at alternative payment models.