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Special report: Radiation therapy on trial

by Nancy Ryerson, Staff Writer | September 30, 2013
From the September 2013 issue of HealthCare Business News magazine

Kerstiens says that at some proton therapy centers, prostate treatment makes up 80 to 90 percent of their cases. For Indiana University’s center, just 25 to 30 percent of the treatments are for prostate. Many of Indiana’s patients are children covered by Medicaid, which provides low reimbursements for the treatment.

Times are even tougher when it comes to for-profit proton therapy centers. ProCure, the largest for-profit chain of proton therapy centers, was in danger of defaulting on a $30 million loan when it missed an interest payment in December 2012. The center’s partner, Cadence Health, agreed to pay $25 million to buy out the center.

Kerstiens collaborated on a paper describing the further challenges debt-financed proton beam therapy centers will face after ACO implementation, which the report says could reduce daily revenues by up to 32 percent.

In light of these financial challenges, it may come as a surprise that so many proton therapy centers are still in development. Kerstiens says some centers are one-room facilities that have sprouted up to become competition for established centers.

“I’ve talked with people in Jacksonville who want to put in a one room center that’s going to be 10 miles away from the University of Florida’s proton center,” says Kerstiens. “It’s been my belief that there should be proton therapy centers on a map that should be similar to what you would see if you look for NBA franchises. What we’re seeing right now is a structure that won’t be sustainable.”

Scripps Proton Therapy Center, for one, has partnered up with several area hospitals to support the new center. The center is slated to open in October.

“I think what we did was unique, but going forward, [working together] is going to be more common because the technology is so expensive,” says Chris Van Gorder, Scripps Health president and CEO. “This isn’t something where you want to have several sites in one community, or even half a dozen in the state of California.”

Van Gorder hopes that future centers will work like more regional hubs where hospitals will allow their physicians to practice.

Clinical trials galore
Meanwhile, proton therapy centers are enrolling patients in clinical trials to help prove the efficacy of various cancer treatments.

“Since we opened in 2006, we’ve treated about 4,500 patients, and about 97 percent are on an outcome tracking study,” says Nancy Mendenhall, medical director of the University of Florida Proton Therapy Institute.

That includes those controversial prostate cases.

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