Specialty Care Models to Improve Quality of Care and Reduce Expenditures Final Rule Summary

On September 21, 2020, CMS placed on public display a final rule that will implement two CMS Innovation Center models focused on providing specialty care to Medicare fee-for-service beneficiaries with cancer and end-stage renal disease, respectively. The final rule is scheduled to be published in the September 29, 2020, issue of the Federal Register. The Radiation Oncology Model provides a bundled payment for an episode of radiation therapy to treat certain types of cancer. The End-Stage Renal Disease Treatment Choices Model makes payment adjustments intended to incent fully-informed beneficiary choices of renal replacement therapy options through adjustments to current payments to facilities and clinicians and by increasing flexibility in the delivery of the kidney disease education benefit. Participation in both models will be mandatory for eligible participants (facilities and clinicians) in selected geographic areas, and both models will begin in calendar year 2021.