Lexology July 17, 2019
Ropes & Gray LLP

On July 10, the Centers for Medicare & Medicaid Services (CMS) issued a proposed rule that would implement and test two new mandatory payment models under its Center for Medicare & Medicaid Innovation (CMMI): the Radiation Oncology Model (RO Model) and the End-Stage Renal Disease (ESRD) Treatment Choices (ETC Model).

The proposed RO Model would make prospective payments to hospital outpatient departments, freestanding radiation therapy centers and physician group practices for radiation therapy (RT) episodes of care.

The proposed ETC Model would make payment adjustments to ESRD facilities and some clinicians caring for beneficiaries with ESRD, to encourage greater use of home dialysis and kidney transplants.

Both models would be mandatory, operating in selected geographic areas. CMS announced the proposed...

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Topics: Bundled Payments, CMS, Govt Agencies, Health System / Hospital, Insurance, Medicare, Payment Models, Physician, Primary care, Provider, Value Based
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