Russian doll.

For those of you in practice, the hot topic right now are the swirling rumors of a bundled payment system for radiation oncology. We got more details late last week from an internal CMS transmittal notifying Medicare contractors of plans for final development and implementation of the bundled payment model. It sounds like the model will initially effect “randomly” selected core-based statistical areas (CBSA). CBSA’s are generally metro or micropolitan areas and their surrounding counties—think service area if you live in a CON state. The model will pay half upfront and half at completion of a 90-day block of management for 17 different cancer types. TBL: We’ll see how many are left standing in the conventionally fractionated whole breast radiation camp when everything’s bundled. | CMS Top Secret Transmittal 2019