CMS Radiation Oncology Model proposed rule – summary and early insights

Last week, the Centers for Medicare & Medicaid Services (CMS) announced new details of a proposed bundled payment model for radiation oncology services (RO Model), which would make fundamental (but temporary) changes to the way that Medicare pays for radiation therapy in certain randomly chosen geographic areas.

Under the proposed model, Medicare would pay model participants (including hospital outpatient departments, physician group practices, and free-standing radiation therapy centers) a predetermined, site-neutral bundled rate for most services provided in a 90-day episode of radiation therapy, rather than paying for each service individually. The proposed model would be mandatory for participants located in selected geographic areas. The model is intended to incentivize participants to deliver radiation therapy services more cost-effectively while maintaining or improving the quality of care delivered.

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