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Comment & Response
March 10, 2020

Radiation Oncology Alternative Payment Model

Author Affiliations
  • 1Department of Radiation Oncology, University of North Carolina at Chapel Hill
  • 2Division of Radiation Oncology, Arizona Oncology Tucson, Tucson
JAMA. 2020;323(10):999. doi:10.1001/jama.2020.0400

To the Editor Drs Howard and Torres provided a synopsis of the alternative payment model for radiation oncology proposed by the Centers for Medicare & Medicaid Services (CMS).1 Four points deserve further consideration.

First, the scope and mandatory participation are radical departures from previous alternative payment models that have largely been voluntary with limited participation. Of radiation oncology episodes for traditional fee-for-service Medicare patients, 40% will be included in the Radiation Oncology Model. Thus, 60% of the specialty essentially will be assigned to a control group and 40% to an experimental group. From 2013 to 2015, this would have included more than 250 000 episodes of care.2 The model should be piloted via an evidence-based approach to assess its function and consequences before a widespread mandate is adopted.