News & Updates

October 19, 2011

Site of Service Cost Differences for Medicare Patients Receiving Chemotherapy, Milliman, October 19, 2011

National spending on cancer care in 2010 is estimated at $125 billion. About 8 million of the almost 14 million Americans living with cancer are over age 65, and approximately half of cancer care spending is associated with Medicare beneficiaries.  Approximately 12% of active cancer patients among Medicare beneficiaries receive chemotherapy in a given year, and the total healthcare costs for these beneficiaries is about three times the cost (Medicare allowed) of other cancer patients not receiving chemotherapy, as described later in this report.  The authors have published similar findings for commercial patients.

This paper examines differences in the cost of care for Medicare fee for service cancer patients depending on the site of chemotherapy service.  In recent years, the site of service for chemotherapy has received attention as Medicare reimbursement policy continues to change. Most chemotherapy is delivered in oncologist’s offices, although another common site for chemotherapy is a hospital outpatient facility.

Read full document: Site of Service Cost Differences for Medicare Patients Receiving Chemotherapy