Co-Chair Radiation Oncology Focus Group, Providence Health, St. Joseph Hospital, Eureka, California.
Tennessee Oncology, Nashville, Tennessee.
J Am Coll Radiol. 2022 Jan;19(1 Pt A):53-60. doi: 10.1016/j.jacr.2021.09.030. Epub 2021 Nov 8.
Radiation oncology reimbursement methodology has been largely unchanged over the past 30 years, and new approaches are of great interest to practicing radiation oncologists and other health care stakeholders. Traditional radiation oncology reimbursement is based on a series of individual codes for evaluation and management (professional) and technical services, yielding a complex reimbursement system. In an attempt to move toward a simpler, episodic payment model, bundling all of the codes into a single payment, an alternative payment model for radiation oncology was developed. The radiation oncology alternative payment model is a revolutionary change in how radiation oncologic services will be reimbursed and has potential to affect all aspects of radiation oncologic care. Here, the authors review the origin of the currently proposed radiation oncology model and discuss potential implications of this model on the provision of care, especially as it relates to rural practices and other underserved and vulnerable patient populations.
过去 30 年来,放射肿瘤学的报销方法基本保持不变,新方法引起了从事放射肿瘤学的医生和其他医疗保健利益相关者的极大兴趣。传统的放射肿瘤学报销基于一系列用于评估和管理(专业)和技术服务的单独代码,形成了一个复杂的报销系统。为了尝试转向更简单的、按时间收费的支付模式,将所有代码捆绑到一个单一的支付中,开发了一种放射肿瘤学的替代支付模型。放射肿瘤学的替代支付模型是放射肿瘤学服务报销方式的革命性变化,有可能影响放射肿瘤学护理的各个方面。在这里,作者回顾了目前提出的放射肿瘤学模型的起源,并讨论了该模型对护理提供的潜在影响,特别是与农村实践和其他服务不足和弱势患者群体的关系。