CMS delays radiation oncology payment model following fierce opposition from physician community
The Centers for Medicare and Medicaid Services has decided to delay the start of its mandatory radiation oncology bundled payment model following fierce opposition from the physician community.
CMS had planned to launch the effort on Jan. 1; however, the go-live date will now move to July 1, 2021, Administrator Seema Verma announced Wednesday.
“The [CMS] team and I have listened to the feedback from [the American Society for Radiation Oncology] and the radiation oncology community regarding the start date of the new Radiation Oncology Model and understand that more time is needed to prepare,” she tweeted Oct. 21, calling the initiative “an important part of our strategy to strengthen Medicare and improve cancer care for patients across our country.”
The American College of Radiology had also expressed “alarm” over the initiative, concerned that CMS was rushing the rollout and including too many small practices. ASTRO said Wednesday that it “appreciates” CMS’ decision to postpone, calling the announcement “an important recognition of the radiation oncology community’s concerns.”
“We are hopeful that the delay represents the first step toward full, open engagement with ASTRO on ways to ensure that the RO Model achieves our shared goals of higher quality, lower cost cancer care,” Theodore DeWeese, MD, chair of the society’s board of directors, said in a statement. “We remain seriously concerned with excessive payment cuts in the model that will cause significant financial strain on practices and risk patient access to radiation treatments.”
The Centers for Medicare and Medicaid Services first finalized the long-awaited RO model on Sept. 18. Its goal is to create more predictable payments in cancer care, incentivize the use of cost-effective treatments, and save the agency $230 million over the next five years. The model will do so by providing bundled payments during a 90-day episode of care to radiotherapy providers treating one of 16 different cancer types. It will require participation from physicians in randomly selected geographic areas that contain about 30% of all eligible Medicare fee-for-service radiotherapy episodes nationally, a number that also raised concerns for ACR earlier this month.
Marty Stempniak has covered healthcare since 2012, with his byline appearing in the American Hospital Association's member magazine, Modern Healthcare and McKnight's. Prior to that, he wrote about village government and local business for his hometown newspaper in Oak Park, Illinois. He won a Peter Lisagor and Gold EXCEL awards in 2017 for his coverage of the opioid epidemic.