CMS recently unveiled a new payment model for radiation therapy for cancer patients that is set to launch Jan. 1 and expected to save Medicare $230 million over five years.
The Centers for Medicare and Medicaid Services first finalized the model on September 18, creating a bundle-payment system during a 90-day episode of care with radiotherapy providers that treats 16 different cancer types. Their aim was to make more predictable payments in cancer care and incentivize the use of cost-effective treatments. But the effects on Medicare patients and physicians for the sake of saving money are immense. Clinics will suffer the loss of money, there will be lower volumes of care available, and more negative effects.
ASTRO insists that requiring radiation oncologists to start the model so soon will force the already-suffering radiology clinics dealing with staff shortages and other challenges during the COVID-19 pandemic.
The American College of Radiology even penned a letter to federal leaders voicing their concerns over the effects of the program, written by ACR chief William Thorwarth Jr., MD. Thorwarth believes that forcing 30% of radiation oncology clinics is going too far and affecting physicians who are already struggling to survive. The 30% outlined is actually a reduction from what CMS originally wanted, which was 40% of all eligible Medicare radiotherapy clinics nationally.
The proposed happy solution? ASTRO chairman Theodore DeWeese recommended that CMS begin with a voluntary model, and then transition to a mandatory system that will also allow for exemptions for practices with low volume and hardship.
But will Congress agree at this time when the presidential race is up in arms? The impending presidency in January will also have be a major factor in CMS’ decision whether to proceed or not.