Over the coming weeks, CMS will unveil a mandatory Medicare payment model for radiation oncology, Alex Azar, Health and Human Services secretary said in a recent speech. The announcement drew a mixed reaction from the American Society of Radiation Oncology (ASTRO).
“While ASTRO is enthusiastic about the prospects for a radiation oncology alternative payment model (RO-APM), we have concerns about the possibility of launching a model that requires mandatory participation from all radiation oncology practices at the outset,” an ASTRO statement read.
According to a 2017 value statement from ASTRO, the RO-APM achieves three primary goals identified by the Society’s Payment Reform Workgroup:
1. It rewards radiation oncologists for performance in quality initiatives which improve healthcare value for patients.
2. RO-APMs ensure fair and predictable payment in both the hospital and community cancer clinics to safeguard patient access.
3. The payment model incentivizes appropriate use of cancer treatments, resulting in high quality care and patient outcomes.
“ASTRO has worked for many years to craft a viable payment model that would stabilize payments, drive adherence to nationally-recognized clinical guidelines and improve patient care," said ASTRO CEO Laura Thevenot, in the same statement. “ASTRO believes its proposed RO-APM will allow radiation oncologists to participate fully in the transition to value-based care that both improves cancer outcomes and reduces costs.”
"We want to advance models like these in a collaborative manner. That has been a key priority for this administration since day one," Azar said in the speech. "But there is nothing virtuous about maintaining outdated systems within Medicare fee-for-service—effectively a mandatory system for so long—when we know we could be exploring better alternatives."