MOC-linked radiation oncology care associated with lower Medicare costs

Radiation oncologists who voluntarily participated in American Board of Radiology maintenance of certification were more likely to use contemporary radiation therapy techniques and had lower Medicare costs per treatment course, according to a study in Academic Radiology.

The paper, titled “Impact of Maintenance of Certification in Radiation Oncology on Utilization and Medicare Costs,” was authored by Thomas P. Kole, MD, PhD, and Albert Heuer, PhD, of Rutgers University’s School of Health Professions.

Kole and Heuer conducted a retrospective analysis of the CMS Medicare Part B Public Use File. They used Healthcare Common Procedure Coding System codes for radiation oncologists to assess technique-specific utilization rates, Medicare costs, and treatment course length by MOC participation status.

Radiation oncologists certified before 1995 could hold lifetime certificates and were not required to participate in MOC. ABR’s current continuing certification program covers diagnostic radiology, radiation oncology, interventional radiology, and medical physics, and lifetime certificates remain valid even if diplomates opt out of ongoing maintenance.

Less than 10% of lifetime certificate holders voluntarily participated in MOC, according to the study findings summarized by Radiology Business. Participating physicians more often used advanced techniques, including intensity-modulated radiation therapy and stereotactic body radiation therapy.

Those differences were associated with shorter treatment durations, lower Medicare professional costs per physician, and 10.31% lower Medicare costs per radiation treatment course.

“In essence, this could equate to patients served by ‘grandfathered’ radiation oncologists who elect not to participate in MOC being deprived of the latest standards,” Kole and Heuer wrote.

Medicare reimbursement is a major policy issue in radiation oncology. The Medicare Physician Fee Schedule uses relative value units, geographic practice cost indices, and a conversion factor to calculate payment rates, according to ASTRO’s Medicare reimbursement resources.

The authors cautioned that the findings should not be read as proof of causality. They also noted that low voluntary participation among lifetime certificate holders may reflect dissatisfaction with MOC and limited evidence linking MOC with outcomes or best-practice adoption.