In response to the Centers for Medicare & Medicaid Services' (CMS) request for comment on their proposed advanced alternative payment model (APM) for radiation oncology, the American Society for Radiation Oncology (ASTRO) submitted comments and issued the following statement on Sept. 16 from Paul Harari, MD, FASTRO, Chair of the ASTRO Board of Directors:
"ASTRO appreciates CMS' decision to move forward with an alternative payment model for radiation oncology and believes there are some positive elements in the proposed Radiation Oncology Model (RO Model). We are concerned, however, that the proposal by the Agency falls short of meeting three key goals established by ASTRO for the successful development of an alternative payment model. These goals are that the RO Model should:
We recognize that CMS has sought to align some of the proposal with the Radiation Oncology Alternative Payment Model concept paper that ASTRO submitted in April 2017. Key elements from that paper are found in the proposed rule including the prospective payment; the episode trigger mechanism, timeline and clean period; establishment of distinct professional component and technical component payments; the inclusion of all modalities of treatment; and key quality measure elements. We thank the Agency for recognizing the effort that ASTRO has put into the development of an APM for radiation oncology.
However, an ASTRO analysis estimates that the RO Model would cut payments to required participants by approximately $320 million during the 5-year period—an excessive amount that would undermine this unique opportunity. For the model to be successful, ASTRO recommends specific, significant changes to the proposal that will incentivize the use of high-quality, efficient radiation therapy treatments that drive value-based reform while still providing savings for Medicare. A summary of the key issues and corresponding ASTRO recommendations follow:
We believe the RO Model, with significant modifications, could represent a meaningful and viable first step toward enabling the field of radiation oncology to participate in the evolving world of health care payment reform as initiated by MACRA. We are committed to working with the Agency to modify the model in such a way that it meets the stated goals."
A copy of ASTRO's full response is available here.Back To Top
ASTRO provides comments to CMS on proposed radiation oncology alternative payment model. Appl Rad Oncol.