May 17, 2022 —Radiation oncologists将于今天会见国会领导人和工作人员请求他们支持加强癌症治疗的可及性和公平性的政策。Today’sAmerican Society for Radiation Oncology (ASTRO) Advocacy Dayis the first to be held in-person since the start of theCOVID-19pandemic.
Radiation oncologists and medical physicists from across the country will participate in more than 100 meetings, where they will urge lawmakers to:
- Preserve access to care through stable Medicare payments and a fair radiation oncology alternative payment model
- Prevent prior authorization delays and disruptions for people needing urgent cancer treatments
- Increase federal investments in radiation oncology research and advance health equity measures to eliminate cancer disparities
More than one million people receiveradiation therapyeach year to treat cancer and other diseases. Radiation oncologists are calling on Congress to continue its longstanding support of patients and the larger cancer care community, with an emphasis on three legislative priorities:
ASTROAsk #1:Support stable, value-based Medicare payments for radiation oncology that will improve access and quality, advance equity and reduce costs
Radiation oncologists provide thousands of cancer cures to people each year and offer patients significant value through cost-effective care. Despite these contributions, radiation oncology has faced more Medicare physician payment cuts than any other medical specialty, including cuts for radiation therapy in community-based clinics that total 20% over the last 10 years.
Millions of dollars in additional cuts are forthcoming due to clinical labor price updates scheduled for the next four years. Clinics faced with such significant cuts often have no choice but to reduce vital staff and services, cancel technology investments and, in some cases, close or consolidate – limiting patient access to cancer treatments.
While ASTRO agrees that updates to clinical labor pricing are needed, such steep reimbursement cuts – up to 10% for several key cancer treatments – are untenable. Radiation oncologists therefore are asking members of Congress to support legislation this year to mitigate existing and forthcoming cuts to radiation oncology and other specialties under the new clinical labor price update. Radiation oncologists also are calling for major reforms to Medicare’s physician payment system to stop the annual cycle of cuts and ensure stability, access, value and equity.
“Medicare is not meeting its obligation to maintain fair and stable payments,” saidLaura Dawson, MD, FASTRO, Chair of the ASTRO Board of Directors. “These excessive reductions jeopardize access to life-saving radiation therapy services for Medicare beneficiaries at a time when clinics are recovering from theCOVID-19pandemic and treating patients with more advanced cancers.”
In April 2022, theCenters for Medicare and Medicaid Services(CMS) announced an indefinite delay to the radiation oncology alternative payment model (RO Model). The model’s excessive payment cuts and administrative burden have drawn significant criticism from the radiation oncologycommunityandbipartisan members of Congress. ASTRO remains committed to value-based payment for radiation oncology, however, and is developing a new proposal for an alternative payment model to share with stakeholders later this year. The new proposal will emphasize ways to help patients from economically and socially marginalized groups access and complete radiation treatments.
道森博士说:“我们仍然相信，放射治疗服务的分期付款有很大的潜力来改善获取和质量，促进健康公平和降低癌症护理成本，我们将继续倡导实现这些目标的建议。”
ASTRO Ask #2:Restrict excessive prior authorization practices that delay patient care and waste health care resources
Prior authorization is consistently ranked by radiation oncologists as the biggest challenge facing their clinics, and radiation oncology faces themost prior authorization hurdlesof any medical specialty, causing unnecessary anxiety, delays and harm for people already dealing with the burden of cancer.
十分之九的放射肿瘤学诊所负责人说，他们的病人因为事先获得授权而延误了癌症治疗，大多数人说，平均延误持续一周或更长时间。Researchhas linked each week of delay in starting cancer therapy with a 1.2% to 3.2% increased risk of cancer death. Seven in 10 radiation oncologists say their patients regularly express concerns about their treatment delays due to prior authorization.
虽然放射肿瘤学家面临着不成比例的大量事先授权障碍，但这些问题遍及整个美国医疗保健系统。An April 2022reportfrom the inspector general’s office of the Health and Human Services Department concluded that 13% of Medicare Advantage prior authorization requests, or about85,000 beneficiaries, were improperly denied in 2019.
“Obstructive prior authorization practices create potentially life-threatening delays to cancer treatment,” said Dr. Dawson. “Despite well-intentioned goals to manage health care utilization and control costs, this broken process ultimately harms patients and wastes health care resources. ”
The Council for Affordable Quality Healthcare estimated that$686 millionin spending was associated with conducting prior authorizations in 2021. A separate study calculated a$40 millionannual financial impact for the time required to secure approvals at academic radiation oncology clinics.
ASTRO is one of more than 450 organizations asking lawmakers to pass theImproving Seniors' Timely Access to Care Act of 2021(H.R. 3173; S. 3018), which currently has 292 bipartisan co-sponsors in the House and 24 bipartisan co-sponsors in the Senate, to bring much-needed transparency and oversight to the prior authorization process and help curb delays for people receiving cancer treatment.
ASTRO Ask #3:Support increased research funding for radiation oncology to enable continued innovation and state-of-the-art care
Bipartisan support for cancer research hascontributedto averting 3.2 million deaths from cancer in the U.S. in the past three decades. The COVID-19 pandemic, however, threatened this progress: millions ofcancer screeningswere delayed, 80% of non-COVIDclinical trialswere stopped or interrupted and valuable resources were diverted from cancer research. Radiation oncologists, therefore, are asking lawmakers to renew and increase support for the National Institutes of Health (NIH) and the National Cancer Institute (NCI), in contrast to the 3% decrease in NCI funding proposed in the president’s FY2023 budget.
Earlier this month, ASTROaskedNIH Director Douglas Lowy, MD, for increased funding specifically for radiation oncology research. Radiation therapy is partially or fully responsible for 40% of all cancer cures, yet NIHforecasts表明放射肿瘤学研究占2022财年NCI预算的不到6%。
“Investment in radiation oncology research creates outsized benefits for the public, with the potential to improve cure rates and provide palliative relief for millions of people,” said Dr. Dawson. “Federal funding also supports cutting-edge technologies – such as radiopharmaceuticals, precision medicine and powerful new combinations of cancer therapies – that increase survival and improve our patients’ quality of life.”
In addition to asking for increased research funding, radiation oncologists will focus on several related initiatives: ASTRO strongly supports theDIVERSE Clinical Trials Act(H.R. 5030/S. 2706) to improve representation of individuals from minority populations in clinical research by removing barriers to participation. Radiation oncologists also are urging lawmakers to ensure that the recently reignitedCancer Moonshotinitiative supports efforts to enhance radiation therapy access, address disparities in care and treatment outcomes and reduce obstacles to care. Finally, radiation oncologists are asking for adequate funding for the Advanced Research Projects Agency for Health (ARPA-H) that does not pull funding from other NIH programs.
For more information:www.astro.org
August 11, 2022
