Executive dilemma: Opt for best cancer treatment or pick one that pays the most
New research finds that the more effective cervical cancer treatment is losing ground to an increasingly popular alternative that pays more.
What do hospital executives do when they find that the best therapy ends up costing them money? Many health systems treating cervical cancer are now facing that difficult choice.
The evidence is clear that cervical cancer is most effectively treated with brachytherapy, a form of radiation, according to a new study from the University of Virginia School of Medicine. But the researchers also found a slow and steady decline in the use of brachytherapy because it's cost-prohibitive.
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Medicare reimbursement, as a counterpoint, makes the less-effective external beam radiation four times more profitable, the researchers determined.
UVA research determined that offering brachytherapy for locally advanced cervical cancer ends up costing hospitals money because it takes 80-plus percent more physician personnel time to administer brachytherapy than it does to deliver the increasingly popular external beam radiation. Both methods deliver radiation to the tumor, but brachytherapy delivers much greater doses in a more targeted manner.
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Overall, the researchers determined that it costs hospitals more than twice as much to provide brachytherapy as it does to provide external-beam radiation. But the reimbursement doesn't reflect that. The comparatively poor reimbursement rates may mean some hospitals simply don't offer brachytherapy or commit physician time to it.
Brachytherapy is a requirement of curative therapy, the study said, but providing brachytherapy results in a net loss for the healthcare facility.
Ultimately, it's a quality issue that's running up against a financial challenge. It's a steeper hill for rural and smaller hospitals that don't do a lot of brachytherapy than for large systems and academic medical centers, such as UVA, which are equipped to provide brachytherapy -- and to absorb the major resource commitment that comes with it, the researchers said.
It underscores a hard truth: If a hospital doesn't run a profit greater than zero, it folds.
How does your hospital handle this dilemma?
Twitter: @JELagasse
Email the writer: jeff.lagasse@himssmedia.com
