Practice Consolidation Among U.S. Radiation Oncologists Over Time.

Area of Science:

• Oncology
• Health Services Research
• Health Economics

Background:

• Healthcare practices nationwide are consolidating due to market pressures.
• Practice consolidation varies by specialty and is understudied in radiation oncology.

Purpose of the Study:

• To analyze the extent of practice consolidation in U.S. radiation oncology.
• To identify market factors associated with this consolidation.

Main Methods:

• Utilized Medicare data (2013, 2017) on radiation oncologist practice size and billing.
• Categorized practices as solo, small (2-10), or large (11+).
• Quantified market consolidation using the Herfindahl-Hirschman Index within hospital referral regions (HRRs).

Main Results:

• Radiation oncology practices are highly consolidated (mean HHI 0.4711 in 2013, increasing to 0.4865 in 2017).
• The number of solo practices decreased 11%, while large practices increased 50% between 2013-2017.
• Large practices employed more oncologists (32.4%) and handled more Medicare billing (26%) by 2017.

Conclusions:

• Radiation oncology is a highly consolidated medical specialty in the U.S.
• A significant trend towards larger group practices is evident, with nearly one-third of oncologists in the 90 largest practices by 2017.
• Further research is needed to understand the implications of this consolidation.