Arlington, Va., Apr 03: A new national survey released by the American Society for Radiation Oncology (ASTRO) reveals that recent Medicare payment changes are placing severe financial strain on cancer clinics and jeopardizing patient access to radiation therapy, a cornerstone of modern cancer treatment.
The survey of U.S.-based radiation oncologists found that a significant majority are experiencing sharp reimbursement declines following federal payment changes that took effect January 1. While federal estimates projected an overall reduction of about 1% for the specialty, more than two-thirds of respondents reported cuts of 10% or more, with some clinics facing reductions as high as 20–30%.
“These findings point to a serious and immediate threat to cancer care in the United States,” said Sameer Keole, MD, FASTRO, Chair of the ASTRO Board of Directors. “Radiation therapy plays a vital role in improving survivorship rates, but these cuts are potentially catastrophic for patient access across the country.”
Widespread Impact on Community Clinics
The survey highlights widespread financial challenges across both freestanding and hospital-based practices, with the most severe effects reported among independent, community-based clinics. Physicians warned that closures or service reductions could force patients—particularly in rural and suburban areas—to travel long distances for treatment.
Clinics are already responding to financial pressures by implementing hiring freezes and layoffs, including reductions in clinical staff. Some respondents described operating under critical deficits, raising concerns about their ability to remain open.
“Community-based radiation oncology practices are lifelines that provide critical access to care,” added Keole. “When these centers scale back or close, patients don’t stop needing care—it simply becomes harder for them to receive it.”
Patient Access and Outcomes at Risk
Radiation therapy typically requires daily sessions over several weeks, making proximity to treatment centers essential. Increased travel distances can lead to higher costs, treatment delays, and poorer outcomes for patients.
The survey also found that operational challenges tied to new billing code structures are compounding the issue. Nearly half of respondents reported frequent delays or denials of advanced treatments by insurers, driven by prior authorization requirements and administrative hurdles.
Physicians noted growing administrative burdens, payment delays, and claim denials, further straining already stretched resources.
Long-Term Trends and Policy Concerns
ASTRO emphasized that the current situation builds on a decade-long trend of declining reimbursement rates, which have dropped by more than 25% even as the cost of care delivery has risen. These pressures have contributed to increased consolidation within the field, reducing competition and creating gaps in access to care.
“What we are seeing now is the tipping point,” Keole said. “Without intervention, clinic closures and consolidation will accelerate, further limiting access to cancer care.”
Call for Urgent Action
ASTRO is urging policymakers, including Medicare officials and Congress, to take immediate steps to stabilize reimbursement and protect access to cancer care—particularly for vulnerable community-based practices.
The organization also supports bipartisan legislative efforts, including the proposed Radiation Oncology Case Rate (ROCR) Act, aimed at aligning reimbursement with the true cost and complexity of care.
“This is not an abstract policy issue—it is a direct threat to patient care,” Keole emphasized. “We need urgent action to ensure patients can continue receiving high-quality cancer treatment close to home.”
