That was my assessment of this section, which I probably found like you did (control F "protons" and this was all that popped up). All it's doing is asking the gov't to reassess the impact at 7 years.
smaller than me = 0 docs or 0 linacs, but I wouldn't put it past em to exclude me.
Da carveouts. Unconscionable. 10 year exclusion from time of implementation
There you go.
absolutely; some kind of go fund me would also make a performative statement to asto and the field., At the very least I will reach out to my congressman. Is there anyway to conduct a poll on this site to demonstrate how many of us are against this?
Yeah...the rapidly expanding abuse of "image guided" superficial XRT for non-melanomatous skin cancer is a real problem. It is extraordinarily low value and worse than what most of us do (non-image guidance electron therapy) from a fundamentals standpoint most of the time.
It's not even just private practice. This is screwing solo hospital employed docs. Literally all ASTRO cares about protecting are the academic systems. They want a cartel where every LINAC is controlled by an academic system with new grads rotated out to the cornfields to directly supervise. Private equity leveraged buyouts would be preferable to this.
10 years for Big Rad Onc to marginalize, bankrupt, and absorb Little Rad Onc. Then they acquire all the broken pieces at pennies on the dollar and all of a sudden:
The same types of people run big academia and private equity. Schools are now there to support endowments, not the other way around. Faculty have known this (particularly in the humanities and basic sciences). Medical faculty are the last to put up a fight, because they are the best compensated. Medical faculty leadership may well be considered rent seekers in this fiasco.
I don't recall it either. Took the place of MR Linac, I guess.
Correct - academic institutions are now essentially hedge funds which offer courses on the side
I'm sure student loan forgiveness will fix all of it. Just take all the pretense away that the tax base is being directly funneled to their endowments giving them carte blanche to charge whatever they want for tuition and increase their administrative bloat exponentially.
Not a huge fan of accreditation, but I think it won't be too onerous.
An external audit by whom and to what standards? Surely ensuring direct supervision at all times.
ROCR sets conditions for a huge competitive advantage for large centers, pps and proton, to expand and bring more patients under their high cost umbrella. Ultimately, payments are very disconnected from CMS rates. Almost zero patients have pure medicare. Hospital negotiated prices are going up not down. If this was so great for our reimbursement, why would they exempt themselves.
Isn’t there an anti-trust argument to be made here? Requiring accreditation and you’re one of the 3 groups providing accreditation? Policies that directly favor their centers preferentially (carve outs etc)? Didn’t someone post a link for reporting anti-trust to the government recently?
Try and mandate direct supervision for the entire profession but then exclude yourself from ROCR. Sounds about right. Dictator level stuff.
Sounds like a conclusion sentence from a red journal fluff article.
Somewhat off topic but your ability to make Star Wars references is unrivaled
STS?
The srt exclusion makes zero sense to me. It's a scam igrt wise and it isn't even good for patients when it's used inappropriately on larger tumors
It’s about how the case rate is calculated, which is by looking at existing reimbursement. SRT would drive down the average case rate reimbursement for skin cancer, since on average SRT reimburses less than electrons nationally (if skin cancer is included in the model, I don’t know that it is).
With the bogus igrt ultrasound charges, it reimburses far more
There is a company out there selling linacs for electrons to derms because of the better pro forma than SRT if treating >15-20 patients/month. Seriously. And there are derms in the southeast doing it.
SRT as a practice expanding into the community through places like SkinCure is markedly increasing cost per case for skin cancer care.
