Fair play.

If you couldn’t quite make it through the entire RO-APM proposal, this article is here to help. While the RO-APM is well-intentioned, these authors suggest the proposed incentives may have missed their mark. For example, disease site-specific bundled payment calculations currently include palliative-intent and partially-completed treatments, dropping the estimated average payment by 4-6% across all 17 disease sites. Second—and you can either follow their excruciating “simplified” payment calculations or just trust them as we did—historic reimbursements are hugely influential, and not in the way you might assume. Practices who more commonly employ hypofractionation and other resource-efficient treatments will have their bundled payments adjusted down, while those still treating prostate cancer over 2 months will have theirs adjusted up. Finally, there is an automatic 4-5% slash (more than that of the Oncology Care Model, might we point out) in reimbursements across the board, with an opportunity to earn back only on professional, not technical (i.e., 80-90% of total reimbursement), fees. TBL: Logical input from actual radiation oncologists into the RO-APM can increase equity, encourage participation, and help realize its overarching goal of delivering quality cancer care. | Thaker, J Oncol Pract 2019