The delivery system for community-based oncology care continues to experience significant change and complexity. In 2014, the Centers for Medicare & Medicaid Services released the Medicare Provider Utilization and Payment Data: Physician and Other Supplier Public Use File.
The Medicare PUF files are vital new data sources for examining the number of outpatient oncology and haematology services. Data are presently available for 2012 and 2013.
The 2014 National Practice Benchmark survey reported an average of 6,000 wRVUs per physician for a similar selection of services, but that number included all oncology patients, not just Medicare beneficiaries. The 537 physicians who participated in the 2014 NPB survey seem to be producing approximately the 80th percentile of the Oncology Composite identified in the ASCO PUF.
The Medicare allowable amount for each of the treatments was $2,994.11, and the Medicare payment amount was $2,333. The drug’s effective provider cost was $2,814; therefore, after receiving payment from Medicare, the providing physicians needed to collect an additional $481.05 to recover the cost of acquiring the drug.
Comparing the supply of oncologists by the state to the wRVU and the SEER estimates of cancer incidence by state reveals intriguing differences in physicians’ distribution and the demand for oncology service. This analysis demonstrates this work’s application in two discrete areas, but many more applications are possible and will be addressed in future work.
Ref: https://ascopubs.org/doi/full/10.1200/JOP.2015.008516
