Economic Implications

Quality of care considerations aside, the existing fee-forservice model of medical care in the United States (including the traditional Medicare plan) does not provide a strong economic incentive for the provision of interdisciplinary cancer care. Administrative costs associated with the establishment and support of these teams cannot be passed on to insurers. Although Medicare has developed a modifier that provides reimbursement if a patient is seen by several physicians in the same clinic in 1 day, physicians cannot bill for time spent at treatment planning conferences.

Theoretically, there are economic advantages that could result from an interdisciplinary approach to cancer treatment. In Market Driven Health Care, Dr. Regina Helzlinger predicts that consumers are increasingly demanding integrated disease-focused care.132 If so, then institutions providing such services may have an advantage in the medical marketplace regardless of the reimbursement model.133 In addition, the interdisciplinary team may contribute to optimal resource utilization and efficient work flow. Data do not exist to facilitate a more rigorous return-on-investment analysis pertaining to interdisciplinary cancer care.

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