The Centers for Medicare & Medicaid Services (CMS) introduced a new episode-based payment model through the Center for Medicare and Medicaid Innovation that will test prospective episode-based payments for radiation oncology therapy.
Participants will include physician group practices, hospital outpatient departments, and freestanding radiation therapy centers. The model is intended to reduce Medicare expenditures and improve quality of care.
Under the model, CMS would make prospective, episode-based payments based on a patient’s cancer diagnosis. These payments would cover radiotherapy services furnished in a 90-day episode for the 17 cancer types meeting the included criteria. The model would establish a common, adjusted national base payment amount for each episode, regardless of where it is furnished, and transition to site-neutral payments.
Participation would be mandatory for providers that furnish services within randomly selected geographic areas.
The five year model is projected to begin on Jan. 1 or April 1, 2020, and end Dec. 31, 2024.
Contact Senior Director of Policy Erin O’Malley at firstname.lastname@example.org or 202.585.0127 with questions.