ASTRO 🔫🦶

[sirspamalot]

Out here in 'Murica where smokers smoke, and men are men..

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[evilbooyaa]

Can we just... NOT do the stage III NSCLC 4DCT discussion again

 

[Ray D. Ayshun]

Can we just... NOT do the stage III NSCLC 4DCT discussion again

#4DCTorGTFO

 

[Lamount]

Can we just... NOT do the stage III NSCLC 4DCT discussion again

Lol I forgot how contentious it was

 

[pikachu]

Can we just... NOT do the stage III NSCLC 4DCT discussion again

It’s the first week of July though… when everything old is new again…

 

[sirspamalot]

Oh yeah, we're doin it again!

'Murica!

 

[IonsAreOurFuture]

I am really surprised that Medicare Advantage plans are exempted under this proposal. They account for about half of all Medicare enrollees now and will probably surpass traditional Medicare patients next year. This is a huge piece of the govt payor pie.

To me, these Medicare "dis-Advantage" plans are even more abusive in denying standard treatments, because the only way they can increase shareholder value year over year is to cut more procedures next year than the last. They can't raise Medicare reimbursement rates, only Congress or CMS can do that. I guess they do lie to the govt about how sick their patients are, that's one way to artificially inflate their rates, but regulators are catching on to that one.

 

[RickyScott]

MA plans will just follows cms at discount

 

[NotMattSpraker]

I am really surprised that Medicare Advantage plans are exempted under this proposal. They account for about half of all Medicare enrollees now and will probably surpass traditional Medicare patients next year. This is a huge piece of the govt payor pie.

To me, these Medicare "dis-Advantage" plans are even more abusive in denying standard treatments, because the only way they can increase shareholder value year over year is to cut more procedures next year than the last. They can't raise Medicare reimbursement rates, only Congress or CMS can do that. I guess they do lie to the govt about how sick their patients are, that's one way to artificially inflate their rates, but regulators are catching on to that one.

Is this even possible? It’s a different part of Medicare and wonder if it’s outside what CMS is willing to negotiate. Similar to the PPS exempt exclusion.

 

[IonsAreOurFuture]

I think IMRT (circa 2005) and SBRT (circa 2010) were really the last steps forward. Protons ain't nothing but a financial grind. FLASH if it pans out, maybe. Other than that, we are just spewing minutiae. I have my cynicism level set to 99.8% that we will make any further meaningful advances.

Well, except for "Radiation + (latest) IO removes need for (insert surgical procedure/s)!" if we aren't totally eradicated by "25 fractions, 5 fractions, NO FRACTIONS.. .GGGGG G GGGG GONE!"

I agree that the last decade unfortunately hasn't had a lot of breakthroughs in Rad Onc.

I blame technology stagnation. The Truebeam is now a dozen years old and just about every small town in my state has one, so everyone and no-one is special now.

I used to think Immunotx plus RT was going to be the path forward, but sadly abscopally curing everyone hasn't pannned out. I think the only modality left that has a lot of headroom for innovation is going to be particles, unless you know somebody with a Gamma ray laser. (private message me if you do)

 

[RadOncDoc21]

I agree that the last decade unfortunately hasn't had a lot of breakthroughs in Rad Onc.

I blame technology stagnation. The Truebeam is now a dozen years old and just about every small town in my state has one, so everyone and no-one is special now.

I used to think Immunotx plus RT was going to be the path forward, but sadly abscopally curing everyone hasn't pannned out. I think the only modality left that has a lot of headroom for innovation is going to be particles, unless you know somebody with a Gamma ray laser. (private message me if you do)

What’s there to gain? I think SBRT gives good LC so higher doses don’t seem to be an advantage. I also think toxicity studies will lack true significant advantages.

I’m a believer that a new paradigm will become available in the future but it’s not going to be a fancy new treatment delivery machine.

Of course I could be wrong.