Radiation oncologists are asking lawmakers to join the bipartisan cosponsors of the Holding Providers Harmless from Medicare Cuts During COVID-19 Act of 2020 (H.R. 8702), which would stabilize Medicare payment levels for the next two years and provide temporary relief from the threat of additional cuts for radiation oncology and other medical specialties.
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Since CMS introduced the Radiation Oncology Model (RO Model) as a proposed advanced alternative payment model (APM), ASTRO has expressed significant concerns with the model's mandatory and excessive reimbursement cuts for radiation therapy providers. While these concerns were echoed by bipartisan Senators and Representatives in oversight letters to CMS that requested changes to the model, they were not addressed in the agency's final rule. Radiation oncologists are now asking Congress to intervene and protect patient access to radiation therapy treatments.
The RO Model in its current form would be a significant burden for the 950 practices required to participate, particularly as most are already experiencing revenue declines due to COVID-19. ASTRO surveys of practices from the spring and summer of 2020 indicated that patient volume dropped at nearly 9 in 10 radiation oncology practices due to the pandemic, with an average decline of 31%. Half of the practices also had to reduce staff due to declining patient volume.
"The cuts to providers in the Radiation Oncology Model substantially exceed those in other models and, astoundingly, became more severe between the proposed and the final iterations from CMS," said Dr. Eichler. "We are concerned that these mandatory cuts will financially jeopardize practices' ability to deliver optimal care during the five-year demonstration period, especially as we continue to face a public health emergency. Unfortunately, CMS’ failure to listen to our recommendations has turned a model with great potential to improve patient care into one that we’re seriously worried will undermine patient care."
Radiation oncologists are asking specifically for the RO Model's discount factors to be more consistent with other specialty models and more in line with the intent of value-based health care reform as outlined by the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). Additionally, while an ASTRO-led effort recently secured a delay in the model's start date from January 1 to July 1, 2021, physicians will stress that without significant changes, the delay only represents a stay of execution from the massive cuts. ASTRO appreciates the bipartisan leadership of Reps. Brian Higgins (D-N.Y.) and Rep. Mike Kelly (R-Penn.), who are leading a joint letter to CMS asking for essential reforms to the RO Model before its implementation.