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Radiation Oncology Capital Decisions and Equipment Replacement

 

Seven to ten year commitments, replacement timing, and what a capital decision commits you to.

 

Medsolve Dynamics validates oncology capital decisions before the commitment is locked in, including equipment replacement timing and total cost across the life of the asset.

 

Short field notes, recorded as they came up. Newest first.

 

 

The Vendor Landscape Just Widened. Your Capital Conversation Changed Whether You Know It Or Not.

May 27, 2026 · Listen

At ESTRO 2026, United Imaging showed a CE-marked uRT-linac 506c on the show floor. Diagnostic-CT integrated with a linear accelerator on a single platform. Online adaptive radiotherapy positioned without an MR-linac, without a third-party planning system, and without RaySearch. Reported as CE marked in Europe. Not yet in the US market. Capital decisions in flight in the US in 2026 are not changing because of what showed up in Berlin. What changed is the leverage map on every conversation around them.

 

What Does This Commit Us To In Year Five? The Question Every Oncology Capital Decision Needs

May 15, 2026 · Listen

Capital decisions hold up when the year-five reality is considered before the signature. They break when only year-one numbers are. From 20 years on the vendor side and now on the program side, the year-five question that protects margin through a multi-year operating commitment in radiation oncology.

 

Why The Old Capital Math Does Not Survive The 2026 Reimbursement Environment

May 6, 2026 · Listen

A short clip from the AMAC Spring Symposium 2026 talk on the discipline programs need to apply to every capital decision in the current environment. Forward-looking, not policy-blame.

 

The allure of new technology without a clear problem to solve!

April 9, 2026 · Listen

A physicist's excitement about a new tool without a clear problem to solve.

  • Tool adoption without a clear problem.

  • The allure of new technology.

 

Structuring Capital and Service Agreements in Oncology Programs.

March 17, 2026 · Listen

Yoel Bakas has experience on the vendor side, helping oncology program structure capital and service agreements. He emphasizes the importance of validating and aligning assumptions before committing capital, as fixing issues after Go Live is expensive.

  • Capital and service agreements require multi-year operating commitments.

  • Validating and aligning assumptions before committing capital is crucial.

 

The impact of thoughtful sequencing on technology success and failure.

March 17, 2026 · Listen

The impact of thoughtful sequencing on technology success and failure.

  • Sequencing is crucial for technology success.

  • Operating model readiness is key for technology implementation.

 

Capital decisions often fail due to unvalidated assumptions.

March 17, 2026 · Listen

Capital decisions often fail due to unvalidated assumptions and lack of reflection of reality. The fix is to validate reality before locking decisions.

  • Unvalidated assumptions lead to capital decision failures.

  • Validate reality before locking decisions.

 

Growth failure is often a result of execution issues.

March 17, 2026 · Listen

The conversation delves into the multifaceted nature of margin target challenges in oncology programs, highlighting the various factors that contribute to missed targets. It also emphasizes the importance of recognizing that growth failure is often a result of execution issues rather than the failure of the growth strategy.

  • Multiple factors contribute to missed margin targets in oncology programs.

  • Growth failure is often a result of execution issues, not the failure of the growth strategy.

 

More field notes: Building a proforma · AI validation · all seven topics

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