A study published in the “Annals of Surgical Oncology” provides some encouraging news for patients facing a diagnosis of mesothelioma. Researchers have found that the way that insurance companies are reimbursing hospitals for a variety of treatments is actually improving outcomes in the treatment of peritoneal mesothelioma.
The study was conducted by surgical oncologists at Winship Cancer Institute in Atlanta, Georgia, and it compared the money that a hospital spends on mesothelioma treatment against the amount of money that facilities receive in reimbursement.
Mesothelioma is an aggressive and always fatal form of cancer that is caused by exposure to asbestos. When the disease takes hold in the lungs it is called pleural mesothelioma, and when it occurs in the lining of the organs of the abdomen it is called peritoneal mesothelioma.
One of the most innovative treatment options available for those suffering from peritoneal mesothelioma is a procedure called CRS/HIPEC treatment. CRS stands for cytoreductive surgery, and is the removal of a mesothelioma procedure, and HIPEC stands for heated intraperitoneal chemotherapy, which follows the tumor surgery and pours heated chemotherapy drugs into the cavity to kill remaining mesothelioma cells.
The procedure, which is extremely intensive and which takes a long time, is known to have a positive impact on patient survival. The procedure is expensive, but researchers found that when privately-insured patients have the procedure and experience major complications, hospitals end up making money. This is not the case for Medicaid patients with mesothelioma who undergo the CRS/HIPEC treatment – on those patients the hospitals lose money.
In looking at over five dozen mesothelioma patients who received the CRS/HIPEC treatment for a number of different types of cancers at Emory University, sixty-six percent experienced complications, which meant that the hospital made over $36,000 per patient.
The loss that hospitals suffered when complications occurred in Medicaid mesothelioma patients averaged over $54,000 per patient. But with bundled insurance payments about to start, hospitals will receive reimbursement for patients when they experience fewer complications.
According to author Dr. Malcolm H. Squires, “With these impending changes, hospitals must place emphasis on value, recalculate the reimbursement necessary for financial viability, and focus on decreasing costs and minimizing complications.”