Skip to main content

Verma: Radiation Oncology Model Delayed Until July 2021

Analysis  |  By Jack O'Brien  
   October 21, 2020

The CMS Administrator tweeted that "more time is needed to prepare" for the mandatory payment model.

Centers for Medicare & Medicaid Services (CMS) Administrator Seema Verma announced Wednesday afternoon that the agency intends to delay the Radiation Oncology Model until July 2021. 

Verma tweeted that "more time is needed to prepare" for the mandatory payment model.

"The @CMSGov team & I have listened to the feedback from @ASTRO_org & the radiation oncology community regarding the start date of the new Radiation Oncology (#radonc) Model, & understand that more time is needed to prepare," Verma tweeted. "The #radonc Model is an important part of our strategy to strengthen #Medicare & improve cancer care for patients across our country, so we intend to delay the model until July 2021 through upcoming rule-making."

The payment model was first proposed in July 2019 and was slated to run through 2024, while being managed by the CMS Innovation Center.

Related: CMS Proposing Bundled Payment Model for Radiation Oncology

Writing in Revenue Cycle Advisor, a sibling publication to HealthLeaders, Valerie Rinkle, MPA said CMS would make payments for radiation therapy services "furnished in 90-day episodes for each of the 16 cancer types."

Additionally, Rinkle said that after an episode ends, patients requiring radiation therapy services would see those services excluded from the model for 28 days.

"If the patient needs radiation therapy services after 28 days from the end of the last episode, another episode would begin," Rinkle wrote. "Also, an episode is not complete if the radiation delivery or TC is not started within 28 days of the PC episode initiation."

Related: Q&A About Payments for New Radiation Oncology Model

Theodore L. DeWeese, MD, FASTRO, chair of the board of directors for the American Society for Radiation Oncology (ASTRO) hailed Verma's decision in a statement released Wednesday evening.

"This change is an important recognition of the radiation oncology community’s concerns, and we are pleased and thankful that Administrator Verma listened to the needs of our member radiation oncology practices during these challenging times," DeWeese said. "We are hopeful that the delay represents the first step toward full, open engagement with ASTRO on ways to ensure that the RO Model achieves our shared goals of higher quality, lower cost cancer care."

After the CMS proposal was announced, it was called "a step forward in allowing the nation's 4,500 radiation oncologists to participate in the transition to value-based care" by Paul Harari, MD, then-board chair for ASTRO.

However, other healthcare stakeholders, including the American Hospital Association and the Community Oncology Alliance, bashed the proposal.

Three months after his initial comments, even Harari said the proposal fell "short" of three key goals advanced by ASTRO.

Related: Stakeholders Rap CMS Mandatory Radiation Oncology Model

Editor's note: This story has been updated to include commentary from the American Society for Radiation Oncology.

Jack O'Brien is the Content Team Lead and Finance Editor at HealthLeaders, an HCPro brand.

Tagged Under:


Get the latest on healthcare leadership in your inbox.