By Dave Adler, Vice President, Advocacy
The coronavirus is challenging the nation’s health care infrastructure in unprecedented ways, and radiation oncology clinics are adapting to this rapidly changing environment in response to the crisis. Similarly, ASTRO’s advocacy must adjust course on key priorities, including tackling new initiatives to support the membership’s response to this crisis and a shift to ensure a smooth transition to value-based payments, particularly at this challenging time.
On March 10, the long-awaited Center for Medicare and Medicaid Innovation’s (CMMI) Radiation Oncology Model (RO Model) moved to its final stage of review at the Trump administration’s Office of Management and Budget (OMB). This final review could last a few weeks or even months before the agency publicly releases the details of this all-important regulation for implementing the model. Even during these final days of government review, ASTRO continues to advocate strongly for necessary reforms to what CMMI proposed last summer, including major changes to the scope of the model and the payment methodology.
ASTRO has expressed concern to CMMI about the potential that one-third of all oncology practices would be required to implement the model on July 1, which CMMI has said is its goal, leaving only a few months for practices to review the final rule details and make practice changes to implement the model. ASTRO also has shared concerns about the aggressive implementation timeline with radiation oncology champions on Capitol Hill, particularly since the model has taken so long to be released.
In recent days, as the coronavirus crisis has spiked and nearly every aspect of the health care system and our daily lives have been impacted, causing ASTRO’s concern with the planned implementation timeline to be exacerbated. We are hearing from both freestanding centers and hospital-based clinics that the combined burden of addressing the coronavirus and implementing the likely mandatory RO Model would be overwhelming.
Data from China indicates that cancer patients are at greater risk of contracting the COVID-19 virus and have poorer outcomes once infected. Radiation oncology practices are making drastic coronavirus-related preparations and changes, such as postponing follow-up visits and non-urgent treatments. Practices report that non-essential staff — such as coding and billing staff that would play a major role in RO model implementation — are now working from home, while some hospitals are retraining clinical staff to help handle the expected surge in coronavirus patients.
Given this highly disruptive, but hopefully short-term emergency, ASTRO is reaching out to CMMI and Congress to discuss a delay in implementation. While ASTRO wants the RO Model, with our recommended reforms, implemented sooner rather than later, this situation necessitates delay to allow radiation oncology clinics, their patients and the broader health system to combat the crisis facing our country.
ASTRO also has heard from members that are seeking best practices for how to deal with the coronavirus, and ASTRO advocacy is working to help. ASTRO has been in contact with senior Centers for Disease Control and Prevention (CDC) officials, and we’ve requested that the agency provide coronavirus-specific recommended best practices and considerations for cancer patients. We hope to have more information from the CDC soon.
Unfortunately, due to travel restrictions placed on our members and the importance of reducing the risk of coronavirus transmission, ASTRO has cancelled Advocacy Day 2020. While this premier advocacy meeting is called off until 2021, the spirit of advocacy must continue. It’s important for the radiation oncology community to continue to push Congress and the administration for policies that support high-quality cancer care. To that end, ASTRO will be providing members with opportunities to communicate issues virtually, including direct conversations with Congress on existing priorities and new issues brought to the forefront.
Stay tuned as we roll these changes out in the coming weeks in a manner that supports your essential mission of serving your patients and communities during this challenging time. Please comment below or via the ROhub on how the coronavirus is impacting your practice and patients and how ASTRO can support radiation oncology at this time.