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• W2757363716 abstract "Intensity modulated radiation therapy (IMRT) is a unique RT modality that allows for improved dose conformality as compared with traditional RT. Although IMRT has been associated with improved toxicity profiles in certain disease sites, many patients can still safely and effectively be treated with more traditional and less costly modalities. In this study, we sought to examine the variation in IMRT utilization among radiation oncology providers in the United States treating Medicare patients. The Medicare Physician and Other Supplier Public Use File (POSPUF) was queried for radiation oncologists practicing during the year 2014. Common Procedural Terminology (CPT) codes were gathered for each provider and defined as follows: 77261, 77262, and 77263 as simulations; 77295, 77305, 77310, 77315, and 77321 as non-IMRT planning; and 77301 as IMRT planning. Providers who had not billed for a simulation (n=450) or IMRT code (n=1,507) were excluded from analysis. Providers were coded as “academic” if they self-identified their primary employer as an “Academic/University System” in the ASTRO member directory. A total of 2,736 radiation oncologists met inclusion criteria. The top 20% of utilizers of IMRT accounted for 43.5% of IMRT plans. Factors associated with both a higher rate of IMRT use and a higher number of IMRT plans per distinct beneficiary on univariate analysis included academic practice, technical fee billing, and freestanding clinic practice (Table 1). On multivariate analysis, male gender, academic practice, technical fee billing, and freestanding clinic practice were associated with a higher rate of IMRT use. The top ten utilizers of IMRT billed an average of 227 IMRT plans per year with 1.49 plans per beneficiary (as compared to a median among all providers of 26 IMRT plans and 1.02 plans per beneficiary). Of these ten individuals, all had billed technical fees and practiced in nonacademic freestanding clinics. There is variation in IMRT utilization by provider gender, practice location, and type of practice. While the majority of providers had a relatively low utilization rate, a small group of outliers shared a number of common demographic and practice-based characteristics.Abstract 2944; Table 1Baseline provider and practice demographics by intensity modulated radiation therapy (IMRT) utilizationAll providers (%)IMRT per total simulationp valueIMRT plans per distinct beneficiaryp valueGenderMale2,187 (80%)0.440.0251.070.909Female549 (20%)0.411.07Type of practiceNonacademic2,123 (78%)0.42<0.0011.08<0.001Academic613 (22%)0.481.05Billed technical feesYes1,123 (41%)0.52<0.0011.10<0.001No1,613 (59%)0.371.05Place of serviceFacility1,803 (66%)0.37<0.0011.05<0.001Freestanding933 (34%)0.551.10 Open table in a new tab" @default.
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• W2757363716 date "2017-10-01" @default.
• W2757363716 modified "2023-09-27" @default.
• W2757363716 title "Evidence or Excess-Based? Intensity Modulated Radiation Therapy Utilization Among Elderly Patients in the United States" @default.
• W2757363716 doi "https://doi.org/10.1016/j.ijrobp.2017.06.1553" @default.
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