Consensus on Payment Model Reform amongst Radiation Oncologists: The Radiation Oncology Payment Reform Survey, Preliminary Results



Abstract

Purpose: Traditional Medicare payments for Radiation Oncology (RO) services adhere to a fee-for-service (FFS) model; however, stakeholders have growing interest in transitioning to an episode-based (EB) payment model. Several novel models have been proposed, including the Center for Medicare and Medicaid Innovation’s (CMMI) Radiation Oncology Model (RO Model) and the American Society for Radiation Oncology’s (ASTRO) Radiation Oncology Case Rate (ROCR) program. The level of support for EB payments among RO physicians, and their opinions on elements of proposed models, is poorly documented. The present survey was designed to gain physician insight through confidential and efficient means, enhance transparency, promote dialogue, and assess consensus.

Methodology: The Government Relations and Economics Committee (GREC) of the American College of Radiation Oncology (ACRO) created a 29-item questionnaire aimed at evaluating respondent viewpoints on EB payment structures and elements of proposed payment models. RO attending and resident physicians were identified using American Medical Association (AMA) Physician Professional Data and ACRO membership records. The questionnaire was distributed electronically via email to a comprehensive list of physicians with verified email addresses. Each recipient received a unique hyperlink that permitted only a single response. All personally identifiable information was omitted from the data collection process to preserve anonymity. The survey commenced on October 2nd, 2023, and collection is ongoing as of November 17th, 2023. Participation was promoted via word-of-mouth, social media posts, and direct email campaigns. Physicians were afforded the opportunity to update the email address used for survey delivery through an online form.

Results: Survey collection will continue until a predetermined response rate is reached. Preliminary trends indicate significant interest and engagement from physicians. Rigorous and reproducible statistical analysis will be conducted, including evaluation of subgroups based on respondent experience level and practice variables. A comprehensive assessment will explore physician opinions towards EB payment structures and other issues central to modern clinical RO practice.

Conclusions: This study, the first-of-its-kind to report the contemporary sentiment of practicing Radiation Oncologists, seeks to underscore the specialty’s readiness for payment reform and may be used to inform future policy-making and legislative advocacy. Detailed insights will be presented at The Radiation Oncology Summit: ACRO 2024.

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abstract
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Consensus on Payment Model Reform amongst Radiation Oncologists: The Radiation Oncology Payment Reform Survey, Preliminary Results


Author Information

Joseph A. Wilding

Radiation Oncology, Virginia Commonwealth University, Richmond, USA

Christopher D. Jahraus

Radiation Oncology, Generations Radiotherapy & Oncology PC, Alabaster, USA

Dwight E. Heron

Radiation Oncology, Bon Secours Mercy Health, Youngstown, USA

Jason McKitrick

n/a, Liberty Partners Group, Washington DC, USA

James S. Clifford

Department of Public Health, East Carolina University, Greenville, USA

Cecil M. Benitez

Radiation Oncology, University of California Los Angeles, Los Angeles, USA

Tarita O. Thomas Corresponding Author

Radiation Oncology, Northwestern University Feinberg School of Medicine, Chicago, USA


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