I think the lack of answer to that question is because noone who reads or posts on this board understands it either.
I asked my chair to explain it to me the other day, but still don't understand it well enough to give a great explanation here. Nevertheless, I'll try.
A few of the points were that the whole utilization term/percentage only applies to machines > or = to $1 million. CMS then estimates how much the value of that machine depreciates on a yearly basis. They then adjust reimbursement accordingly to account for that decrease in value. If they assume only a 50% utilization rate (meaning you use it only about half of the potential "usable time") they have to increase reimbursement to account for the depreciation. If they bump up the utilization to assume a 90% rate, then the reimbursement does not have to be as high to cover the depreciation. As I understood it, it only applies to technical fees. It will be a huge deal for diagnostics, but obviously affect rad onc as well. Not just for treatment, but even more so for CT simulations, because we only do so many per day, as opposed to a diagnostic CT scanner where they jam as many people into the day as possible.
Hope that clears it up at least a little. If anyone else has anymore insight, feel free to chime in as I'm not claiming to be an expert on such matters.
Cheers.
Also, great use of the word pontificating