CMS recently announced two new mandatory payment models: Radiation Oncology and ESRD Treatment Choices models. Providers located in selected geographic areas will be required to participate in these models when they launch on Jan. 1, 2021.

The Radiation Oncology (RO) Model will pay physician group practices, hospital outpatient departments and freestanding radiation oncology centers a prospective payment for a 90-day episode of care for radiation therapy for certain cancer types. The prospective payment is based on historical spending and is subject to a discount (3.75% for the professional component and 4.75% for the technical component) and quality withholds.

The ESRD Treatment Choices (ETC) Model will make upward or downward adjustments to payments to ESRD facilities and managing clinicians based on rates of home dialysis and kidney transplants. Additionally, in the first three years, CMS will provide an upward payment adjustment on home dialysis claims.

Watch this on-demand webinar to learn more about these new models and how Premier can help you prepare for participation.

Aisha Pittman
Vice President, Policy, Premier

Elyse Pegler
Principal, Advisory Services, Premier

Wendy Rossi
Principal, Advisory Services, Premier

Melissa Medeiros
Director, Payment Policy and Analysis, Premier