A major restructuring of the way the U.S. Centers for Medicare and Medicaid Services (CMS) pay for radiation therapy treatments, the Radiation Oncology Alternative Payment Model (RO Model), has been delayed again -- this time into the indefinite future. Advocates for radiation oncology say the payment change would have been "punitive" for treatment centers.
In an April 6 proposed rule, the CMS said it was delaying the start of its RO Model from January 1, 2023, to a date "to be determined" through future rulemaking. It's the second time CMS has postponed implementation of the RO Model, which was originally set to go into effect in January 2022.
The RO Model would radically change reimbursement for many radiation therapy practices by bundling radiation therapy payments rather than continuing to pay on the basis of individual treatment episodes. CMS first proposed the RO Model in September 2020.
Advocates for radiation oncology have stated that they support a revision to reimbursement that would support providing therapy to patients with fewer episodes of care. But many objected to what they saw as an overly aggressive implementation schedule for such a radical change in payment.
For its part, the American Society for Radiation Oncology (ASTRO) said it hoped that the delay in implementation of the RO Model would give CMS time to make changes to the program to make it less "punitive" for radiation therapy providers.
"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 Dr. Laura Dawson, chair of ASTRO's board of directors. "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."
