Fact Sheet | Bundled Payment

CMMI Radiation Oncology Model: HFMA Overview

Fact Sheet | Bundled Payment

CMMI Radiation Oncology Model: HFMA Overview

On July 10, 2019, The Center for Medicare and Medicaid Innovation (CMMI) proposed a five-year, mandatory episodic payment model for 17 cancer types treated using radiation oncology. Model participants will receive prospective, episode-based payment amounts for RT services furnished during a 90-day episode of care, instead of regular Medicare fee-for-service (FFS) payments throughout the model performance period. The model’s aim is to test whether episode-based payments to physician group practices (PGPs), hospital outpatient departments (HOPD) and freestanding radiation therapy centers for radiotherapy (RT) will reduce Medicare expenditures, while preserving or enhancing the quality of care for Medicare beneficiaries.  The five-year model is currently projected to begin either January 1, 2020, or April 1, 2020, and end December 31, 2024. CMMI estimates the model will save $260 million dollars over its five-year life by impacting approximately 350,000 episodes. 

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