CMS Announces Innovative Payment Model to Improve Care, Lower Costs for Cancer Patients

Radiation Oncology Model will modernize Medicare payments for radiotherapy services  

On September 18, CMS finalized a new Innovation Center model expected to improve the quality of care for cancer patients receiving radiotherapy and reduce Medicare expenditures through bundled payments that allow providers to focus on delivering high-quality treatments. The new Radiation Oncology (RO) Model allows this focus on value-based care by creating simpler, more predictable payments that incentivize cost-efficient and clinically effective treatments to improve quality and outcomes. The RO Model, part of a final rule on specialty care models issued by CMS, will begin on January 1, 2021 and is estimated to save Medicare $230 million over 5 years.

“President Trump knows that, for cancer patients, what matters is their quality of life and beating their cancer.  But today, Medicare payment for radiotherapy is based on the number of treatments a patient receives and where they receive it, which can lead to spending more time traveling for treatment with little clinical value,” said CMS Administrator Seema Verma. “That’s why the Trump administration has developed a new innovative model that allows patients and providers to focus on better outcomes for patients.”

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These Models are a part of a CMS final rule on Medicare Program; Specialty Care Models To Improve Quality of Care and Reduce Expenditures (CMS-5527-F).