Examining the Financial Impact of Altered Fractionation in Breast Cancer: An Analysis Using Time-Driven Activity-Based Costing

PurposeValue-based care is increasingly informing treatment decisions in radiation oncology. Although reimbursement differences have been examined for accelerated whole breast irradiation (AWBI) and conventional (CWBI), the cost of delivery poorly understood. This article describes our experience evaluating costs altered fractionation early-stage cancer using a time-driven activity-based costing (TDABC) model.Methods MaterialsProcess maps were developed 2 regimens, AWBI (42.5 Gy 16 fractions + 10 4 boost) CWBI (50 25 5 boost). Cost was determined based on aggregate personnel, materials, equipment, space, utilities per unit time relative proportion capacity used. The total each regimen calculated as all billable events during course therapy, 2019 Centers Medicare & Medicaid Services physician fee schedule database.ResultsThe delivering courses $6965 $9267, respectively, difference $2302 (25%). Eighty-six percent this related to lower daily treatments. or $9665 $12,908, $3243 Overall, 55% 60% with remainder utilities, equipment.ConclusionsThis analysis shows how TDABC can be used evaluate resource requirements different therapy schedules. We found substantially compared CWBI, primarily resulting from fewer As emphasis health shifts toward value-based care, help identify opportunities reduce increase clinical efficiency.