Proton Therapy Treatment Centers in Risk-sharing Health Systems

Hospital systems across the country are increasingly vying to establish some of the first treatment centers to provide proton beam therapy, a high-tech radiation treatment for cancer. Johns Hopkins Medicine and MedStar Health are just two of the more recent organizations who gained the seal of approval for their own proton centers, both which are valued at $153 million. While there are currently 11 proton treatment centers in the US, 17 other centers are in development, including hospital systems like the Maryland Proton Treatment Center in Baltimore, MD.

Although promising, proton technology is almost twice as expensive as standard photon radiation, and there is currently little evidence that it provides more effective care than cheaper treatments.

Dr Ezekiel Emanuel, a former healthcare advisor, suggested that neither Johns Hopkins nor MedStar Health should be building such centers. There is concern these high-cost treatment centers will ultimately force taxpayers, employers, and consumers to pay higher health insurance premiums. "We don’t have evidence that there’s a need for them in terms of medical care,” Dr Emanuel said, “They’re simply done to generate profits."

At the Maryland Proton Treatment Center in Baltimore, Center Director Dr Minesh Mehta had a more optimistic outlook on the technology. Dr Mehta said, "At the end of the day, when I tell the patient I can treat you with technology that will treat less of your normal tissue with radiation you don’t need versus more radiation to tissue that should not be radiated, which would you like to choose?” He said that the vast majority of patients will choose the treatment that delivers less radiation to their tissues.

The competing financial nature of the centers seems to conflict with the health systems’ mutual interest in pursuing risk-sharing ventures like Affordable Care Organizations (ACOs). However, ACO business has yet to contest the preference of fee-for-service treatments like proton therapy. As well, many physicians are still attracted to using the most advanced technology available, and consumers typically associate ground-breaking treatments with better quality care.

Until there are stronger incentives to counter volume-based care, Erik Johnson, a senior vice president at Avalere Health, said many hospitals will continue to seek ways to maximize profits in spite of utilizing a risk-based health system. Mr Johnson further commented that the use of proton therapy centers demonstrates that many health systems are continuing to rely on fee-for-service centers, as they do not see ACOs “happening for years to come.”

Around the Web

D.C. Approves Two New Proton Therapy Centers [Kaiser Health News]

Proton Beam Therapy Heats Up Hospital Arms Race [Kaiser Health News]

Of ACOs And Proton Beams: Why Hospitals ‘Live In Two Worlds’ [Kaiser Health News]