They also can impact the disproportionate number of radiation oncologists in rural and urban settings, a situation in which a fewer number of physicians are taking up posts in rural communities. Many already in such areas plan to retire in the next few years or reduce their hours, thereby limiting access to care for patients.

"Stable payments (in the Medicare and Medicaid) are essential to allowing cancer centers to operate and provide high quality care to patients," said Agarwal. "While the results of this study are essential data points, sustained advocacy from all healthcare stakeholders is important in order to make policy changes that ensure reasonable payment and access to critical cancer services."


The study was limited by the exclusion of Tennessee, which does not follow a Medicaid fee-for-service model, and Illinois, the fee schedule for which was incomplete.

The findings were published in the International Journal of Radiation Oncology • Biology • Physics (Red Journal).

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