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Bipartisan bill seeks to revamp Medicare's radiation oncology payments

by HealthCare Business News | May 17, 2024
Rad Oncology
A significant legislative proposal, the Radiation Oncology Case Rate (ROCR) Value-Based Payment Program Act, has been introduced to Congress with bipartisan support, aiming to overhaul how Medicare reimburses for radiation therapy.

Sponsored by Senator Thom Tillis and Representatives Brian Fitzpatrick, Jimmy Panetta, John Joyce, and Paul Tonko, the bill proposes a shift from the traditional fee-for-service model to a value-based system that prioritizes patient needs over the quantity of treatments provided.

The American Society for Radiation Oncology (ASTRO) has expressed strong support for the initiative, highlighting its potential to improve quality, enhance patient outcomes, and reduce health disparities in cancer care. The proposed ROCR program would incorporate episode-based payments, focusing on financially incentivizing treatments that are scientifically proven to be effective, thus aligning provider incentives with patient outcomes.

A notable aspect of the ROCR Act is the Health Equity and Achievement in Radiation Therapy (HEART) initiative. This initiative seeks to address transportation challenges that disproportionately affect rural and underserved patients, enhancing their access to potentially lifesaving radiation therapy. The initiative is inspired by successful outcomes from a National Cancer Institute-funded study that demonstrated improvements in treatment completion and survival rates through targeted support.

Furthermore, the ROCR Act aims to rectify more than a decade of cuts to Medicare payments for radiation therapy, which have been reduced by 23% over the past ten years. By reforming payment structures and reducing administrative burdens, the act strives to provide a more stable and equitable funding environment for radiation oncology services.

ASTRO's advocacy efforts are set to continue, with a large contingent of radiation oncologists scheduled to meet with congressional members to push for the passage of the bill. This concerted push underscores the community’s commitment to securing better outcomes for cancer patients across the United States.

The bill's sponsors and supporters believe that the ROCR Act not only advances significant payment reform but also promises enhanced access to high-quality, innovative cancer treatments for seniors and others relying on Medicare. By redefining how radiation oncology is valued in the healthcare system, the ROCR Act holds the promise of transforming cancer treatment infrastructure to better serve patients and providers alike.

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