Today’s chart comes from the recent GAO report on delivery of intensity-modulated radiation therapy (IMRT) for prostate cancer among Medicare patients by physician groups that do and do not self-refer (h/t Karan Chhabra). Self-referring here means that providers administering IMRT had a financial relationship with the entity that referred the patient for the therapy.
Surprise! Self-referring groups are a growing source of IMRT delivery; non-self-referring groups are not. Remuneration does not imply causation, but the findings are consistent with the idea that physician groups respond to financial incentives.
Some other facts from the GAO report:
- Providers are not required to disclose that they self-refer.
- IMRT is one of the more costly prostate cancer treatment options, but not clearly superior.
- Other work has documented that physicians play a large role in determination of a patient’s prostate cancer treatment approach.
- Other work has also suggests financial incentives may influence treatment decisions.
- Differences between self-referring and non-self-referring providers shown above could not be explained by differences in age, geographic location, or health.