On March 1, 2021, the American College of Radiology® (ACR®) and other radiation oncology stakeholders sent a letter to the Centers for Medicare and Medicaid Services (CMS) regarding the Radiation Oncology (RO) Model. The American Society for Radiation Oncology (ASTRO) led the sign-on letter effort in which stakeholders outlined existing concerns with the RO Model in hopes of working with the new Administration to make changes and achieve shared goals.
The ACR, ASTRO and other organizations in the RO care community believe that the RO Model is overly focused on achieving savings at the risk of hurting access and quality of care, and believe that with reforms made in future rulemaking, the model could serve as an opportunity to advance care for cancer patients.
ACR and RO stakeholders remain concerned with the payment methodology of the model, which includes steep discount factors off the professional and technical components that risk the financial viability of practices. The sign-on letter urged CMS to reduce the discount factors to no more than 3% and to establish a COVID-19 case mix adjustment, among other recommended changes to the payment methodology.
Stakeholders also urged CMS to consider a rate review mechanism for recognizing the need for new equipment and service lines. The letter suggests changes to burdensome quality and clinical data collection and reporting requirements, as well as the significant impact on small and rural practices. Additionally, stakeholders urged CMS to recognize all model participants as Advanced Alternative Payment Model participants.
The ACR remains active in advocacy efforts for the RO Model and has sent letters to CMS in March, July, and October 2020, as well as January 2021.
The RO Model is set to begin on Jan. 1, 2022. For more information on the RO Model, visit the CMS website.