Integrated Medical administered IMRT to 91 male Medicare patients aged 80 and older over the period the Journal examined.
The generous reimbursement rates explain why Dosoretz's company can run its expensive IMRT machines at 50% capacity yet remain highly profitable.
This approach excluded patients who were diagnosed many years ago and who may have undergone other treatments before resorting to IMRT.
WSJ: How The Wall Street Journal Crunched the Medicare Numbers
Integrated Medical treats far fewer patients with cheaper radiation seeds than with IMRT because seeds cause more side effects, Dr. Kapoor said.
Shares of Radiation Therapy Services cooled off in 2006 with Medicare vowing to cut reimbursements for IMRT procedures by 27% over four years.
He also wrote that Integrated Medical's IMRT use was boosted by a large number of treatments of patients who were referred by outside physicians.
Dr. Kapoor said the large difference in costs between IMRT and seed implants was not a factor he and his colleagues took into account in their treatment decisions.
In a separate study they found that IMRT's higher doses let 90% of early-stage patients remain cancer free for five years, up from 77% of patients treated with older methods.
The reason for restricting the universe in such a way was to examine the likelihood that a new prostate-cancer patient would be treated with IMRT as opposed to other less-costly options.
WSJ: How The Wall Street Journal Crunched the Medicare Numbers
Medicare started paying for IMRT in 2002, setting its reimbursement rate for the procedure high to take into account the costs of the technology and the added personnel required to administer it.
Researchers at Memorial Sloan- Kettering reported in 2002 that a mere 4% of 698 prostate cancer patients who underwent IMRT suffered significant rectal bleeding, less than one-third the rate for older technology.
Some in the profession grouse that IMRT is overprescribed--and some doctors who have parted ways with Dosoretz say the company promotes higher IMRT use by offering bonuses for meeting higher revenue targets.
By contrast, the proportion of prostate-cancer patients 80 and older who were treated with IMRT was between 13% and 24% in a half-dozen states where no self-referral groups existed in 2008, the Journal found.
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