CMS officially delays radiation oncology payment model, citing COVID-19’s economic strain

The Centers for Medicare and Medicaid Services has officially delayed the start of its radiation oncology payment model amid worries it could further hobble physicians already reeling from the pandemic.

CMS originally planned to kick off the mandatory bundled-payment program Jan. 1 but will now postpone the go-live date to July. Administrator Seema Verma had hinted at the delay on social media back in October, with the 2021 Hospital Outpatient Prospective Payment System final rule released Wednesday making it official.

The federal agency has received numerous comments in recent months, voicing concerns about revenue losses, decreased patient volumes, and layoffs.

“[Radiation oncology] participants have limited capacity to operationalize RO Model requirements this year because of the unprecedented [public health emergency] that continues to strain healthcare resources,” CMS wrote in the 1,312-page final rule. A six-month delay, it added, will avoid “potentially hindering the delivery of safe and efficient healthcare to beneficiaries receiving radiotherapy services.”

The American College of Radiology had expressed “alarm” over the initiative earlier this year, concerned that CMS was rushing the rollout and including too many small practices. Officials first finalized the long-awaited RO model in September in a bid to save $230 million over the next five years. It would do so by bundling payments to radiotherapy providers treating one of 16 different cancer types, requiring participation from physicians in randomly selected geographic areas.

ACR highlighted the model’s postponement in a summary of the HOPPS rule shared Dec. 2.