Recent data show that radiation oncology services are becoming less available across the United States. This trend is happening at the same time that the federal government is proposing changes to how outpatient services are paid.

最近的數據顯示，美國全國的放射腫瘤治療服務正逐漸減少。與此同時，聯邦政府正擬議更改門診服務的支付方式。

A study in the International Journal of Radiation Oncology*Biology*Physics shows a steady decrease in access to radiation therapy between 2018 and 2025. According to the data, over 50 million people live in counties that have no radiation oncology centers. There is a major difference between cities and rural areas; while cities usually have several options, the closure of one facility in a rural county often means local residents lose all access. This problem is most serious for independent centers that are not part of a hospital, as they lack the money to survive financial difficulties. Furthermore, these closures are more common in areas with lower average incomes and more uninsured patients.

刊登於《國際放射腫瘤學、生物學與物理學雜誌》的一項研究顯示，2018 年至 2025 年間，放射治療的獲取機會穩步下降。根據數據，超過 5,000 萬人居住在沒有放射腫瘤中心的縣。城市與鄉村地區之間存在重大差異；城市通常有多個選擇，但鄉村縣若有一間設施關閉，往往意味著當地居民將失去所有獲取機會。這個問題對於不屬於醫院的獨立中心最為嚴重，因為它們缺乏應對財務困難的資金。此外，這些關閉情況在平均收入較低且未投保患者較多的地區更為常見。

At the same time, the Centers for Medicare & Medicaid Services (CMS) has proposed a 2027 rule to introduce 'site-neutral' payments for imaging services like X-rays and MRI scans. This policy aims to stop paying hospital-owned departments more than independent doctors for the same services. While CMS expects this to save the government $260 million and reduce costs for patients by $70 million, many organizations oppose the plan. Critics argue that these cuts could make hospitals financially unstable, especially in poor regions, which might cause even more services to close.

與此同時，美國醫療保險和醫療補助服務中心 (CMS) 擬定了一項 2027 年的規定，旨在為 X 光和 MRI 掃描等影像服務引入「地點中立」支付方案。此政策旨在停止讓醫院旗下部門在提供相同服務時獲得比獨立醫生更高的支付額。雖然 CMS 預期這能為政府節省 2.6 億美元，並為患者減少 7,000 萬美元的成本，但許多組織反對該計劃。批評者認為，這些削減可能會導致醫院財務不穩定，尤其是在貧困地區，可能會導致更多服務關閉。

Experts have emphasized that these two pressures are happening at once. Dr. Vivek S. Kavadi from ASTRO noted that access was already declining before the 2026 payment cuts, which suggests the healthcare network was already fragile. To solve this, some have suggested new laws, such as the Radiation Oncology Case Rate (ROCR) Act, to create a more stable financial system for healthcare providers.

專家強調，這兩種壓力是同時發生的。來自 ASTRO 的 Vivek S. Kavadi 博士指出，在 2026 年支付削減之前，獲取機會就已經在下降，這顯示醫療網絡早已脆弱。為了le解決這個問題，有人建議制定新法律，例如《放射腫瘤個案率 (ROCR) 法案》，為醫療服務提供者建立一個更穩定的財務制度。

The United States is facing two main problems: a lack of cancer care in rural areas and a shift toward new payment models that may threaten the survival of healthcare providers.

美國目前面臨兩個主要問題：鄉村地區缺乏癌症治療，以及轉向新的支付模式可能會威脅到醫療服務提供者的生存。