One of CMS’ newest models, the Radiation Oncology Model, is mandatory for 30% of all eligible radiation oncology episodes in the country. It tests if moving from a traditional fee-for-service payment setup toward a prospective, site neutral, modality agnostic, episode-based payment system incentivizes the delivery of higher-value care.

Who this model is for

The RO Model is for physician group practices, hospital outpatient departments and freestanding radiation therapy centers that furnish radiation therapy services, with participants categorized as follows:

  • professional participants: physician group practices that provide the professional component of the episode (i.e., treatment planning);
  • technical participants: hospital outpatient departments or freestanding radiation therapy centers that provide the technical component of the episode (i.e., delivery of radiation therapy); and
  • dual participants: freestanding radiation therapy centers providing both professional and technical components of the episode.

Timeline

The anticipated model start date is Jan. 1, 2022. The model has a five-year performance period.

How we can help

DataGen can assist you in preparing for the RO Model. We provide key insight and consultation to help hospitals, health systems, post-acute and other healthcare providers evaluate the RO Model and monitor how effectively their strategies are working to ensure financial stability and high-quality care.

Our Radiation Oncology dashboard allows you to:

  • analyze episode volume by cancer type for both complete and incomplete episodes;
  • compare average episode payments across cancer types;
  • trend episode volume, average episode payments and withhold amounts over time; and
  • compare payments under the RO Model to typical fee-for-service to identify potential loss in revenue.

We offer

  • Performance Period Monitoring for Alternate Payment Model

    We work with providers across the country participating in alternative payment models. DataGen provides key insight and consultation to help hospitals, health systems, post-acute and other healthcare providers evaluate new programs and monitor how effectively their strategies are working to ensure financial stability and high quality care.

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