Saturday, June 16, 2012

An inside view of the medical arms race

Boy, did these guys send an invitation to the wrong guy, but the language they use gives you a sense of how the proton beam juggernaut keeps cutting a swath through the nation's health care budget.  Let's recall, too, that these investments are made possible by your federal government, whose Medicare funding agency, CMS, overpays for cancer therapy using this kind of machine.  Here's the letter:

Dear Paul Levy:

After our two consecutive successful Proton therapy events, it is my great pleasure to invite you to SPEAK at our Third National Conference on "Planning, Building and Operating Successful Proton Therapy Centers" February 20-22, 2013 in San Diego, California. This conference will focus on planning, developing, building and operating Proton Therapy facilities to bring the leading edge of cancer treatment to more patients.  A site tour will be announced shortly.

We are featuring the best Proton Therapy programs nationwide.

When & Where: February 20-22, 2013 ▪ San Diego, California
Presentation: 45min. long classroom-style session focusing on specific best practices/case studies which may include, planning, implementation, etc.
About ACI: This is ACI’s third national proton therapy event, featuring tours of the Roberts Proton Therapy Institute at the University of Pennsylvania and the Hampton University Proton Therapy Institute

Topic Focus: A two-day, case study based industry event focused on how the planning, building and operating of a successful proton therapy centers can help  to meet and exceed the demands of today's oncology patients, gain competitive advantage and improve the quality of care. The goal of this event is to bring industry leaders together, highlight the best practice achievements, as well as discuss the current issues/challenges faced by healthcare executives.

Target Audience:  Administrators from hospital and healthcare systems. Titles including CEO's, Presidents, COOs, CMOs; Administrative Directors of Oncology Services, Cancer Centers, Radiation Oncology and various Oncology Service Directors. Previous conferences have gathered as many as 100 hospital executives from renowned hospitals and health systems around the nation.

Talk Desired: Typically presenters address topics related to best practices, operational success, benchmarks or a case study to represent the growth of a program or service line. You can talk about the success of your program, or more specifically to successful strategies or implementations. We encourage presenters to speak on topics that their peers would be most interested in hearing and a more acquainted subject matter. Some of the topics of interest are:

         *   Seamlessly Integrating Proton Therapy with other oncology services
         *   Ensuring patient safety and compliance with regulations while navigating the regulatory landscape involved in developing a Proton Therapy facility.
         *   Building the business case for a Proton Therapy Center by understanding the clinical applications and future advancements
         *   Effectively measuring the ROI of your cancer service line
         *   Successfully marketing your Proton Therapy Center services to the community to increase patient recruitment, revenue, and competitive advantage.

Please feel free to call or email with any questions or if I can offer you any assistance!  Thank you for your consideration! Please feel free to call or email with any questions!


Anonymous said...

At least Wall Street doesn't use our tax money to fund its excesses, but honestly, in a capitalistic society entrepreneurs go where the money is. So you can't really blame them.
The real question in my mind is why CMS falls for this. I would sure like to know what the process was that led them to pay so much for this unproven therapy - and others. Perhaps this is where we need to concentrate containment efforts.

nonlocal MD

Barry Carol said...

I noticed that conspicuously absent from the list of topics of interest are any mention of either clinical outcomes or cost-effectiveness vs. other treatment alternatives for prostate cancer. From a payer perspective, if it were up to me, I would use reference pricing that would pay for the least costly effective treatment no matter which course of treatment the patient and his doctor decided on. The difference in cost between the reference price and a more expensive treatment approach would have to be covered out-of-pocket by the patient, his family or a charity willing to pay on his behalf. Just because a new drug, device or treatment approach wins FDA approval doesn’t mean that taxpayers (Medicare and Medicaid) or commercial insurers should have to pay for it no matter how much it costs especially when there are less expensive alternatives available.

e-Patient Dave said...

TAKE THE OFFER!!!!!!!!!!!!

Neville Sarkari MD, FACP said...

That's just a sad testament in so many ways.

Rick Borschuk said...

If you were to attend and speak, what would be your message? My guess is that you see this arms race in part a result of competition for business among providers in the health care markets they serve. How do you see the trade offs financially (patient and payer cost) and in clinical improvement of the options of intense competition in a health care market vs. monopoly or oligopoly in that same market, particularly as they impact the arms race, the cost and quality of care, innovation in delivery including devices/equipment, and patient choice? Do you perceive one type of market dynamic preferable to others?

Paul Levy said...


See Barry's and Nonlocal's comments above. Competition and innovation is one thing. This is an aberration brought about by a misguided government pricing policy.

The fact that otherwise thoughtful CMS administrators have found it impossible (politically) to change the manner in which prices are set is an indication of the untoward political influence of certain interest groups in DC. Those interest groups are not guided by the public interest or clinical efficacy.

Susannah said...

As I am wont to say, "You can't make these things up!". Do you think they had any idea who they were inviting to speak? Thanks for the post, and the link to your realier one with the map of proton therapy centers, as I was just talking about them the other day to someone who thought there were decidedly fewer than are shown there. Do you know if anyone has updated that map since 2010, by the way?

Paul Levy said...

I haven't seen an update. Is there anyone out there reading this who has?

Thomas Pane said...

According to this:

The map shows a few more stars than the 2010 version.

Susannah said...

Six more stars, in fact, an increase of almost 50% in about a year and a half. Interesting to note, one center that was under construction is operational, while one seems to have vanished from the map. Was the facility converted into some different sort of treatment center, or is this an error on the web site?

There are five new centers under construction (one of which was only in the developmental stage before) and two new ones being developed. Again, one of the former category, in the Miami area, seems to have been dropped. My read is that even with the enormous payout in reimbursement, these are capital intensive projects that hospitals can't always afford. A final note, there are now two centers overseas, one in Munich and one in Seoul, and I assume their charges are not being set by CMS. I wonder whether other countries are duplicating our pricing disparities, or if there is some other factor at work.