Dear CMS, price matters

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Your government at work. Here’s the pertinent quote from Melinda Beck’s Wall Street Journal article on proton beam therapy:

But some insurers are balking at paying premium rates for proton therapy for such common cancers without more evidence that it does improve patient outcomes—ideally from randomized controlled trials. Several are now under way, but it will be years before results are clear.

Most Medicare regions cover proton therapy for prostate—at about $1,100 per treatment session, compared with $600 for IMRT. But several major insurers stopped after a 2012 study found it has no added long-term benefit. Men with prostate cancer had made up 70{c754d8f4a6af077a182a96e5a5e47e38ce50ff83c235579d09299c097124e52d} of patients at some proton centers; now they are less than half the facilities’ customers nationwide.

It’s time for the government to have the spine and judgment to change its pricing for this therapy.

As I have noted earlier, where are the Triple Aim advocates on this point?


SOURCE: Not Running a Hospital – Read entire story here.

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In their own words

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