CMS proposes radiation oncology payment model: 6 things to know

CMS has proposed a radiation oncology model that it says is designed to improve care quality for cancer patients and allow providers to use a new payment approach.

Six things to know about the proposed model:

1. The model would test prospective, episode-based payments to physician group practices, hospital outpatient departments and freestanding radiation therapy centers for 17 cancer types.

2. It would be tested in randomly selected core-based statistical areas of the U.S.

3. Under the model, payments would cover 90-day care episodes.

4. Each participant's payment would be adjusted for factors including the participant's geographic location and case-mix, as well as proposed national base rates. CMS said it would also apply a discount factor to adjust payments.

5. Payments would be separated by professional component, for radiotherapy services that only a physician may provide, and technical component, for services performed by a nonphysician provider.

6. The model would allow physicians to participate in an advanced alternative payment model or merit-based incentive payment system alternative payment model under CMS' Quality Payment Program.

Read more about the model here


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