Radiation Oncology's Financial Squeeze with Dr Ryan Funk

In this episode of Targeted Talks, Sabrina Serani speaks with Dr Ryan Funk, chief radiation oncology officer at The US Oncology Network and a radiation oncologist with Minnesota Oncology, about the financial pressures reshaping radiation oncology in 2026. While CMS's overhaul of treatment delivery codes into complexity-based tiers has drawn attention, Dr. Funk argues that commercial payer contracts—not Medicare—are the bigger driver of instability, since commercial reimbursement typically funds the margin practices need to reinvest in costly, aging equipment. Dr Funk discusses how practices are responding: tightening collections on contracted payments, delaying staffing cuts, and increasingly facing hard choices about whether to replace linear accelerators at all. He warns that the most visible effect won't be lower-quality care at existing centers, but outright closures, especially among freestanding and rural facilities, which have already seen disproportionate losses over the past decade. Since about half of all patients with cancer require radiation, and access is especially critical for patients traveling daily for treatment, he stresses that this is a multidisciplinary concern, not just a radiation oncology one. The conversation also covers the role of patient advocacy groups, employers, and professional societies like ASTRO and ACRO in applying pressure at both the national and local contract levels, and Dr Funk's advice for physicians to engage more directly with the business side of their practices.