- CMS proposed a new rule to delay indefinitely the implementation of this radiation oncology bundled payments model.
- The Radiation Oncology (RO) model intends to reimburse oncology practices and hospital outpatient sites for total episodes of care.
- CMS will accept comments on the proposal for 60 days from its published date.
CMS has again delayed a new Radiation Oncology model. Initially, in December 2021, the U.S. Congress passed a bill to delay this model’s implementation.
Subsequently, on April 6th, the Centers for Medicare & Medicaid Services (CMS) published a proposed rule. As a result, this rule postponed the implementation of the radiation oncology bundled payments model, leaving the relaunch date unclear
What is this RO model about?
According to the CMS rule, this RO Model aims to improve the quality of care for cancer patients receiving radiotherapy (RT) and move toward a simplified and predictable payment system.
Specifically, the RO model is a mandatory model that tests whether changing how RT services are currently paid—via fee-for-service payments—to prospective, site-neutral, modality-agnostic, episode-based payments incentivize physicians to deliver higher-value RT care.
Moreover, this model aims to reimburse oncology practices and hospital outpatient sites for total episodes of care and will provide site-neutral payments for certain radiation therapies
RO Model has generated major pushback from the oncology industry
The oncology industry alleges this rule will hurt their practices, which are already under strain from the pandemic.
In response, the leaders of the American Society for Radiation Oncology (ASTRO) released a statement applauding the delay of this rule. ASTRO considers the model in its current form too punitive for clinics. Furthermore, the association hopes CMS will make the adjustments recommended by Congress and the broad stakeholders coalition within the radiation oncology community.
As it stands, CMS proposed to delay the model’s current start date indefinitely, which will be determined through future rulemaking. The model will be on hold indefinitely if the proposed rule is finalized.
The delay is intended to help model participants who have invested funding to prepare for the model. CMS will accept comments on the proposal for 60 days from its published date.
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Resources
CMS proposes indefinite delay for Radiation Oncology model already postponed by Congress
CMS Delays Implementation of New Radiation Oncology Payment Model
