Last week CMS dug in with its decision to put off finalizing an alternative value-based payment model for radiation oncology services to “a date to be determined through future rulemaking.”
The American Society for Radiation Oncology issued a statement almost immediately.
Attributing the response to ASTRO’s board chair, Laura Dawson, MD, the organization encouraged the agency to work with practitioners of the specialty on formulating an episode-based, i.e., bundled, approach to reimbursement.
“ASTRO continues to believe that episodic payments will improve access and quality, advance health equity and reduce costs in cancer care,” Dawson says in the prepared remarks posted Aug. 25. “We hope that this official delay provides an opportunity for CMS to work with stakeholders on a new value-based reimbursement structure for radiation therapy.”
More from Dawson on behalf of ASTRO:
Fair and stable Medicare payments are essential to support modern cancer care, especially as clinics face rising inflation costs. We are optimistic that CMS will work more closely with the radiation oncology community on a reformed push for episodic payments.”
ASTRO also points out that it sent CMS a letter in June summarizing “longstanding concerns” held by members of both parties in Congress as well as radiation oncology professionals.
The comments focused on the evident emphasis the currently conceived model places on cost savings over treatment quality.
The June letter also proposed revisions to the standing RO model that, in ASTRO’s estimation, would “foster successful participation from physicians and generate substantial saving for the Medicare program.”
“CMS estimated that the RO Model would create $150 million in cuts to radiation oncology,” the organization states, “compounding the inflation- and utilization-adjusted 27% drop in Medicare reimbursement for radiation therapy services incurred over the past decade.”
More from the Aug. 25 statement:
ASTRO currently is developing a new proposal for an alternative payment model to share with stakeholders later this year. In addition to an emphasis on episodic payments, the new proposal will emphasize ways to help patients from economically and socially marginalized groups access and complete radiation treatments.”
Full ASTRO statement here. Updated CMS page on Radiation Oncology Model here.
Dave P. has worked in journalism, marketing and public relations for more than 30 years, frequently concentrating on hospitals, healthcare technology and Catholic communications. He has also specialized in fundraising communications, ghostwriting for CEOs of local, national and global charities, nonprofits and foundations.