title: Defining the value of magnetic resonance imaging in prostate brachytherapy using time-driven activity-based costing.
abstract: Magnetic resonance imaging (MRI) simulation and planning for prostate brachytherapy (PBT) may deliver potential clinical benefits but at an unknown cost to the provider and healthcare system. Time-driven activity-based costing (TDABC) is an innovative bottom-up costing tool in healthcare that can be used to measure the actual consumption of resources required over the full cycle of care. TDABC analysis was conducted to compare patient-level costs for an MRI-based versus traditional PBT workflow. TDABC cost was only 1% higher for the MRI-based workflow, and utilization of MRI allowed for cost shifting from other imaging modalities, such as CT and ultrasound, to MRI during the PBT process. Future initiatives will be required to follow the costs of care over longer periods of time to determine if improvements in outcomes and toxicities with an MRI-based approach lead to lower resource utilization and spending over the long-term. Understanding provider costs will become important as healthcare reform transitions to value-based purchasing and other alternative payment models.
authors.affiliation: Department of Radiation Oncology, Arizona Oncology, The US Oncology Network, Tucson, AZ. Electronic address: Nikhil.Thaker@USOncology.com.
authors.forename: Nikhil G
authors.initials: NG
authors.lastname: Thaker
authors.affiliation: Department of Radiation Oncology, Dana-Farber Cancer Institute, Milford Regional Medical Center, Boston, MA.
authors.forename: Peter F
authors.initials: PF
authors.lastname: Orio
authors.affiliation: Department of Radiation Medicine at North Shore-LIJ Health System, New Hyde Park, NY.
authors.forename: Louis
authors.initials: L
authors.lastname: Potters
keywords: Brachytherapy; Magnetic resonance imaging; Time-driven activity-based costing; Value; Value-based healthcare delivery