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CMS Delays Start of Radiation Oncology Model

by | Apr 11, 2022 | Articles, News, Open Content

The model, meant to start Jan. 1 of this year, had already been delayed over concerns from key stakeholders, and its start date is now TBD

A model that aims to simplify payments for cancer patients being treated with radiotherapy has had its start date delayed again. On April 6, the Centers for Medicare & Medicaid Services (CMS) published a proposed rule in the Federal Register, CMS-5527-P2, asking that the current start date of the Radiation Oncology (RO) Model be delayed “to a date to be determined through future rulemaking.”

The model, meant to start January 1 of this year, had already been delayed, with the Protecting Medicare and American Farmers from Sequester Cuts Act (P.L. 117-71) enacted on December 10, 2021 prohibiting it from starting earlier than January 1, 2023. The model’s main purpose is to determine if changes to how radiotherapy services are paid encourage physicians to provide higher-value care. The main change, according to information from CMS:

  • Current payment option: Fee-for-service payments
  • Proposed new payment option: Prospective, site neutral, modality agnostic, episode-based payments

However, key stakeholders in the radiation oncology community are concerned that the current version of the model punishes clinics too much, according to a recent statement by the American Society for Radiation Oncology (ASTRO). ASTRO says the delay gives them hope that their suggested changes to the model, along with changes proposed by other stakeholders, will be implemented.

“We believe that the modifications proposed by ASTRO and the radiation oncology community will ensure successful participation among physicians and facilities and produce significant savings for the Medicare program,” said ASTRO board of directors chair Laura A. Dawson, MD, FASTRO, in the statement released last week. “We continue to believe that episodic payments for radiation therapy services have great potential to improve quality and equity while reducing cancer care costs, and we will continue to advocate for proposals that achieve these goals.”