Impact of site of service on chemotherapy costs: Influence of geographic location and diagnosis.

6601 Background: Site of service strongly influences the cost of cancer treatment. The migration of community oncology practices to the hospital based practice setting has generated considerable discussion about the cost differential between these sites. Methods: We examined claims paid for chemotherapy by Aetna from August 2013 through July 2014 for all malignancies as well as breast/colon/lung cancer (BCL). Results: Over this period of time, Aetna paid chemotherapy claims for 46,000 unique members, including 17,000 members with breast, colon and lung cancer (BCL). For all members receiving chemotherapy as well as for members with BCL, 69% received chemotherapy in the office setting (O) and 31% received chemotherapy in the hospital outpatient setting (H). Despite this patient distribution, chemotherapy allowable reimbursement share was 42% for H and 58% for O, indicating a disproportionate share of chemotherapy reimbursement to H. When considering average chemotherapy allowed per member, patients treated...