ARTICLE SUMMARY:
CMS finalizes its indefinite delay of a radiation oncology bundled payment program. Excerpted from Pathways' Pick of the Week August 31: EU Capacity-Building, RadOnc Model on Thin Ice, and More
CMS issued a final rule last week that puts its radiation oncology bundled payment plans on the thinnest ice yet. The Radiation Oncology Model, first formally proposed by the agency in 2019, has already been subject to two delays from Congress in the context of COVID-19. In parallel, CMS and radiation oncologists, and some manufacturers, have battled it out over the details of the program. The site-neutral, episode-based payment was technically supposed to start next January, but in the new rule CMS instituted an indefinite delay, saying that hospitals and other participants need a reprieve from continued investment in a plan with so much timing uncertainty. The agency says it is still committed to coming up with a solution in future rulemaking, but it doesn’t appear much closer to reaching consensus with providers who argue the payment reductions linked to the bundled payment and the mandatory nature of the program won’t support effective patient care. Meanwhile, CMS argues it has reduced discounts as much as it can without having to expand the proportion of facilities mandated into the program to realize the necessary savings.
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