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October 9, 2019

Alternative Payment for Radiation Oncology

Author Affiliations
  • 1Department of Health Policy and Management, Emory University, Atlanta, Georgia
  • 2Department of Radiation Oncology, Emory University School of Medicine, Atlanta, Georgia
JAMA. 2019;322(19):1859-1860. doi:10.1001/jama.2019.15888

Alternative payment models are the centerpiece of efforts to reduce Medicare spending and improve quality of care. A limitation of existing alternative payment models is that most are directed toward primary care clinicians, even though specialists account for 95% of Medicare spending.1 In July 2019, the Centers for Medicare & Medicaid Services (CMS) took a step toward broader inclusion of specialists in alternative payment models by proposing to test an episode-based payment model for radiation oncology.2 (CMS also proposed a new model for end-stage renal disease care.) Unlike previous, specialty-focused alternative payment models, participation in the Radiation Oncology Model is mandatory. The proposal offers a template that could serve as the basis for future efforts to revamp Medicare reimbursements for specialty care.

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