The American Society for Radiation Oncology (ASTRO) applauded the introduction of legislation in Congress on May 15 that could radically change the way Medicare pays for radiation therapy.
The bill, named the Radiation Oncology Case Rate (ROCR) Value-Based Payment Program Act, could shift the way Medicare pays for the treatments from fee for service to a more patient-centered approach, ASTRO said.
"Through ROCR, Congress can build a future where radiation oncology reimbursement is driven by patient needs, not by the number of treatments provided," Jeff Michalski, MD, chair of ASTRO's board of directors, said in a news release.
The bipartisan bill was introduced by Sen. Thom Tillis (R-NC) and Reps. Brian Fitzpatrick (R-PA), Jimmy Panetta (D-CA), John Joyce, MD (R-PA), and Paul Tonko (D-NY). A U.S. House bill number for the legislation is pending.
Essentially, the ROCR Act incorporates the strengths of the indefinitely delayed Radiation Oncology Alternative Payment Model proposed by Medicare, specifically the use of episode-based payments, and addresses its shortcomings, including excessive payment cuts, burdensome administrative requirements, and the absence of a path to reduce disparities, ASTRO said.
Key features of the ROCR Act include the following, ASTRO said:
- It leverages episode-based payments to align financial incentives with scientifically proven outcomes.
- It supports shorter treatments for certain cancers.
- The bill reduces disparities that create barriers for patients from rural and underserved communities to access and complete treatments.
- It implements a systematic approach to improve quality and protect patient safety through practice accreditation.
- It unifies payments across settings based on hospital technical payments.
- The bill generates Medicare savings of approximately $200 million over 10 years.
More than 40 healthcare institutions and organizations have signed on in support of the ROCR ACT. In addition, radiation oncologists from across the country will be in Washington, D.C., May 20 to 21 to advocate for the bill, ASTRO noted.
