Payment cuts to radiation oncology proposed by the Centers for Medicare and Medicaid Services (CMS) could severely impact community-based cancer care across the U.S., according to the results of a survey conducted by ASTRO, the American Society for Radiation Oncology.

Nearly 600 ASTRO members replied to the online survey, which was conducted July 7-11.

A total of 70 percent of respondents indicated they might limit Medicare patients, with 49 percent saying they may no longer accept Medicare patients at all, in response to the cuts. In addition, 35 percent of respondents from free-standing centers said they may close their practice and 64 percent said they may consolidate practice locations.

Cuts also could force practices to scale back on labor and equipment costs. More than half of community-based practices could lay off physicians, and 81 percent may lay off professional staff such as nurses, according to the survey. Ninety-three percent may delay or cancel the purchase of new technology in response to the cuts.

The cuts in question are part of the CMS Medicare Physician Fee Schedule, which was proposed July 6 and would take effect January 1, 2013. Radiation oncology services would face a 15 percent reduction in overall payment, with community-based radiation therapy clinics seeing a 19 percent reduction, according to ASTRO.

Some specific cuts singled out by ASTRO were the portions of the cuts dealing with treatment times. Representing 7 percent of the cuts overall, CMS proposed new treatment times for intensity modulated radiation therapy and stereotactic body radiation therapy.