The Negative Impact of Stark Law Exemptions on Graduate Medical Education and Health Care Costs: The Example of Radiation Oncology

Cost Implications and Complications of Overtreatment of Low-Risk Prostate Cancer in the United States

“…46 Restructuring of payment models and further limitations on self-referral specified by the Stark Law may combat the incentivizing of definitive therapy. 47 The USPSTF recently recommended against PSA-based screening for prostate cancer because of the risks of overdiagnosis and overtreatment. 7 Although the European Randomized Screening Trial for Prostate Cancer showed a 20% relative reduction in prostate cancer mortality with screening, the USPSTF believed that the ratio of 1055 needed to screen to 37 needed to treat to prevent 1 death at 11 years was too high a price.…”

The Impact of Financial Interest in Intensity-Modulated Radiation Therapy on the Utilization of Radiation Therapy for Treatment of Newly Diagnosed Prostate Cancer: A Single Center Experience

“…Recently, these centers have become the targets of intense criticism [ 3 , 4 ]. The detractor's claim that integrated PCa care centers lead to self-referral by financially motivated urologists and radiation oncologists and result in over-utilization of IMRT contributing to the increased cost of health care.…”

“…They further claim that these centers have a negative impact on residency training in radiation oncology by shifting patients away from the academic radiation oncology training programs. Unfortunately, these claims are not substantiated by data, but rather rely on indirect analysis of Medicare claims and a 12% negative impact report from a single 3-point questionnaire survey of 81 radiation oncology training programs [ 3 , 4 ].…”

“…Although not yet validated in the literature, this may allow for improved quality of care and decreased cost. Unfortunately, these efforts have been much maligned in both the media and radiation oncology literature as conduits to increased revenue for the urologists with only debatable patient benefit [ 3 , 4 ]. These reports have not yet been supported by data.…”