In a prior memorandum, we presented evidence documenting the growing share of Medicare oncology volume being billed in the outpatient hospital setting, in comparison to the physician office setting. In this report, we present our assessment of the cost consequences to the Medicare program of patients receiving chemotherapy services in physician offices versus hospital outpatient […]
Medicare’s payment rates often vary for the same ambulatory services provided to similar patients in different settings, such as physicians’ offices or hospital outpatient departments (OPDs). For example, in 2013, Medicare pays 141 percent more for a level II echocardiogram in an OPD than in a freestanding physician’s office. These variations raise questions about how […]
The Moran Company was asked by The US Oncology Network, Community Oncology Alliance, and ION Solutions to conduct a series of analyses regarding the hypothesis that there has been a shift in the site of service for chemotherapy services in Medicare from the physician office to the Hospital Outpatient Department (HOPD). This memo provides detailed […]
Avalere Health analyzed three years of commercial health plan data to examine the differences in the total cost of care for cancer patients based on the site of service of chemotherapy or radiation therapy. Our study compared the average total episode costs for patients receiving treatment for cancer in a physician’s office (including freestanding radiation […]
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, […]