Today, the Centers for Medicare & Medicaid Services released the final rule for the radiation therapy APM. The Rule is available here: https://innovation.cms.gov/media/document/specialty-care-models-rule
This final rule would establish a bundled payment system for 30% of all Medicare radiation oncology episodes effective January 1, 2021. According to the final rule, the RO-APM Model will be mandatory and will test prospective site-neutral, episode-based payments to physician group practices, hospital outpatient departments, and freestanding radiation therapy centers for radiotherapy episodes of care. The RO-APM Model involves 90-day episodes of care in randomly selected geographic areas and in 16 types of cancer.
A Fact Sheet can be found here:
On several occasions, ACRO has highlighted its preference for the inclusion of multiple cancer types and, in particular, a prospective case rate model. It appears CMS has incorporated several of these ACRO proposals. At the same time, ACRO has advocated for any potential radiation oncology bundled payment model to be voluntary, with added incentive payments to provide high-quality and cost-efficient care. Subsequent to the onset of the COVID-19 pandemic, ACRO advocated for a delay to the start date of the model until January 1, 2022. As a result, we are concerned not only with CMMI’s finalization of a mandatory model for radiation oncology patients, but particularly with the January 1, 2021 start date occurring during a pandemic. We will continue to advocate to CMS for a viable radiation therapy APM for our patients.
Your Involvement in ACRO is Critical
Your leaders at ACRO stand ready to do the important and hard work necessary to protect your interests. More than ever, your support as a member of ACRO will be critical to ensuring the continued success of our specialty.