Radiation Oncology Alternative Payment Model

Anticipated start date for the CMS Radiation Oncology Alternative Payment Model is January 1, 2023

The Radiation Oncology Alternative Payment Model (RO Model) is an advanced alternative payment model developed by the Centers for Medicare and Medicaid Services (CMS) in conjunction with the Center for Medicare and Medicaid Innovation. Under this model, Medicare will pay providers a predetermined, site-neutral, bundled rate for most radiation therapy services provided within a 90-day episode of care, rather than paying for each service individually. Participation in the model will be mandatory for select providers. The intended goal of the model is to incentivize providers to deliver radiation therapy services more efficiently while maintaining or improving the quality of care delivered.

Prior to the start of the first performance year, which will likely begin on January 1, 2023 RO Model participants must meet the following requirements:

  • Complete the Individual Practitioner List (IPL)
  • Attest to using 2015 Edition Certified Electronic Health Record Technology (CEHRT)

Both actions may be taken via the Radiation Oncology Administrative Portal.

RO participants will be required to collect quality measure data and clinical data elements for the first performance year.

Beginning with the first performance year, RO Model participants will:

  • Collect data for four quality measures:
    • Oncology: Medical and Radiation- Plan of Care for Pain
    • Treatment Summary Communication-Radiation Oncology
    • Preventive Care and Screening: Screening for Depression and Follow-Up Plan
    • Advance Care Plan

    Collection of the 4 RO Model Clinical Quality Measures (CQMs) will take place from January 1 through December 31 of the first performance year. Participants will submit performance year one data on the four quality measures to CMS in March of the second performance year.

  • Collect Clinical Data Elements (CDEs) for specified cancer sites.
    • Prostate
    • Breast
    • Lung
    • Bone Mets
    • Brain Mets

Clinical data elements collected from January 1 through June 30 of the first performance year and will be submitted to CMS in July of that performance year.

For more information on the RO Model, please visit CMS.

Elekta's Solution for the RO Model

Elekta has developed a comprehensive solution to assist providers in meeting the RO Model Requirements.

2015 CEHRT Requirements

RO Model Participants must attest to using 2015 Edition Certified Electronic Health Record Technology (CEHRT). Customers can ensure they have all components of 2015 CEHRT technology by visiting the Certified Health IT Product List (CHPL) website.

For more information on Elekta's offerings for 2015 CEHRT, please visit costs and guidance.

Quality Measures and Clinical Data Elements Data Collection

MOSAIQ

MOSAIQ supports the following RO Model requirements for RO Participants:

  • Data collection via
    • RO APM Assessment for Quality Measures
    • RO APM Assessment for Clinical Data Elements
    • Data entry via existing fields in MOSAIQ

Quality Measures and Clinical Data Elements Reporting

MOSAIQ Oncology Analytics (MOA Compliance)

MOA Compliance supports the RO Model by providing the following:

  • Reporting
    • Calculates quality measure population data for manual attestation to CMS
    • Overview KPIs and Detailed dashboards allowing participants to identify opportunities for continuous improvements. (Quality Measures and CDEs)
    • Generates CSV submission file for Clinical Data Element submission to CMS
    • Clinical Data Element individual detail records

Note:
Elekta is actively developing solutions that will support customers through the transition and implementation of the RO Model. Click here to request a demo and learn how MOSAIQ Plaza can help you today.

What is the RO APM?

The RO APM is an advanced alternative payment model developed by the Centers for Medicare and Medicaid Services (CMS) in conjunction with the Center for Medicare and Medicaid Innovation. Under this model, Medicare will pay providers a predetermined, site-neutral, bundled rate for most radiation therapy services provided within a 90-day episode of care, rather than paying for each service individually. Participation in the model will be mandatory for select providers. The intended goal of the model is to incentivize providers to deliver radiation therapy services more efficiently while maintaining or improving the quality of care delivered.

Elekta is actively evaluating MOSAIQ Plaza, our suite of digital tools, to develop solutions that will support customers through the transition and implementation of the RO APM. Click here to request a demo and learn how MOSAIQ Plaza can help you today.