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Coming Soon: The Radiation Oncology Model

October 19, 2020

Update: Following feedback shared with CMS, CMS is now delaying the start date of the Radiation Oncology Model to July 1, 2021. The CAHPS® Cancer Care Survey start date has been pushed back to October 2021.

In the summer of 2019, CMS proposed a new Radiation Oncology Model using the CAHPS® Cancer Care Radiation Therapy Survey as part of an aggregate quality score that would drive pay-for-performance for this service. In a recent Federal Register, CMS finalized this proposal with the hopes that it will reduce Medicare costs while potentially improving the care for beneficiaries.

A key takeaway is that CMS will field the CAHPS® Cancer Care Survey to Radiation Oncology beneficiaries starting in April 2021. Radiation oncology providers should not experience any additional cost as a result of implementation of the survey—CMS will pay to pull the sample and conduct the surveys through a selected contractor, so at this time, PRC (as well as other survey vendors) will not be approved survey vendors as CMS is conducting the surveys.

This model has a five-year Model performance period that begins on January 1, 2021 and runs through December 31, 2025. CMS will begin fielding the CAHPS® Cancer Care Survey in PY1, however, CMS will not include patient experience measures in the calculation of the aggregate quality score (AQS) until PY3. Prior to PY3, CMS will propose a set of patient experience domains based on the CAHPS® Cancer Care Survey to use in the AQS calculation.

This model is designed for physician group practices (PGPs), freestanding radiation therapy centers, or Hospital Outpatient Departments (HOPDs), and participation is required for providers within randomly selected areas. CMS has provided a list of the zip codes required to participate here.

For more information, please reference the CMS website for this model.