Proposed Radiation Oncology Alternative Payment Model (RO-APM) may encourage shorter courses of radiotherapy but reduce reimbursements, according to a recent study in JCO Oncology Practice (2020;OP2000495. doi:10.1200/OP.20.00495).
“An episode-based payment model, the RO-APM, has been proposed for Medicare reimbursement of radiation services provided to oncology patients,” wrote Sanford Meeks, PhD, Department of Radiation Oncology, Orlando Health UF Health Cancer Center (Orlando, FL) and colleagues.
Researchers compared historical fee-for-service reimbursement estimates to the RO-APM for advanced radiotherapy treatment of specific cancer types. The advanced techniques analyzed included stereotactic radiosurgery (SRS), stereotactic body radiotherapy (SBRT), online-adaptive SBRT, and proton therapy.
RO-APM reimbursements were similar for SRS, higher for SBRT, and lower for online-adaptive SBRT and proton therapy.
“These data suggest that the RO-APM may have the desired effect of encouraging shorter courses of radiotherapy, such as SBRT,” explained Dr Meeks and colleagues. “However, emerging technologies that require large capital and operating investments may see an overall significant reduction in proposed reimbursement.”—Lisa Kuhns
