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BIPARTISAN BILL TO MODERNIZE RADIATION ONCOLOGY REIMBURSEMENT INTRODUCED IN
CONGRESS


THE RADIATION ONCOLOGY CASE RATE (ROCR) VALUE-BASED PAYMENT PROGRAM ACT WOULD
IMPROVE ACCESS, ENHANCE QUALITY AND REDUCE DISPARITIES IN AMERICAN CANCER CARE

ARLINGTON, Va., May 15, 2024

Today marks a significant milestone in cancer care with the introduction of
bipartisan federal legislation that would revolutionize Medicare reimbursement
for radiation therapy. The Radiation Oncology Case Rate (ROCR) Value-Based
Payment Program Act of 2024, sponsored by Sen. Thom Tillis (R-N.C.) (S. 4330)
and by Reps. Brian Fitzpatrick (R-Pa.), Jimmy Panetta (D-Calif.), John Joyce, MD
(R-Pa.) and Paul Tonko (D-N.Y.) (House bill number pending), would protect
access to high value cancer treatments for patients across the country, enhance
patient outcomes and reduce health disparities while generating savings for
Medicare.

The Radiation Oncology Case Rate (ROCR) program shifts Medicare’s current
payment system to a more patient-centered approach. With advances in cancer
treatment, evidence-based guidelines often recommend shorter courses of
radiation therapy for many patients, yet Medicare’s outdated fee-for-service
approach penalizes radiation oncologists for following best practices in patient
care.

“ASTRO applauds Sen. Tillis, Rep. Fitzpatrick, Rep. Panetta, Rep. Joyce and Rep.
Tonko for their exemplary bipartisan leadership in the fight against cancer.
Through ROCR, Congress can build a future where radiation oncology reimbursement
is driven by patient needs, not by the number of treatments provided,” said Jeff
Michalski, MD, MBA, FASTRO, Chair of the American Society for Radiation Oncology
(ASTRO) Board of Directors. “This bill represents a pivotal turn in how Medicare
values radiation oncology care. By passing it, Congress would ensure that high
quality treatment remains accessible for all patients, especially those in rural
and underserved communities.”

A key feature of the ROCR Act is an evidence-based approach to reducing
disparities in cancer treatment. ROCR’s Health Equity and Achievement in
Radiation Therapy (HEART) initiative would provide cancer centers with funds to
support patients who face transportation hurdles that undermine access to
radiation treatments. HEART is based on a model from a National Cancer
Institute-funded study that reduced disparities, improved treatment completion
and increased survival rates for a community in North Carolina. ROCR expands
this evidence-based policy initiative nationwide.

“It’s tragic when transportation obstacles get in the way of curing cancer. Our
rural and underserved patients deserve better access, and the HEART initiative
will ensure that many more Americans can benefit from radiation therapy,” said
Dr. Michalski.

ROCR would also end more than a decade of cuts to Medicare payments for
radiation therapy. Despite the outsized value that radiation oncology delivers
for patients and Medicare, reimbursements for radiation therapy under the
Medicare Physician Fee Schedule have been cut by 23% over the past decade, more
than nearly any other medical specialty.

ROCR incorporates the strengths of the indefinitely-delayed Radiation Oncology
Alternative Payment Model proposed by Medicare – specifically the use of
episode-based payments – and addresses its shortcomings, including excessive
payment cuts, burdensome administrative requirements and the absence of a path
to reduce disparities.

Key features of ROCR include:

 * Leveraging episode-based payments to align financial incentives with
   scientifically proven outcomes.
 * Supporting shorter treatments for certain cancers, allowing patients more
   time to work and spend time with loved ones.
 * Reducing disparities that create barriers for patients from rural and
   underserved communities to access and complete treatments.
 * Implementing a systematic approach to improve quality and protect patient
   safety through practice accreditation.
 * Unifying payments across settings based on hospital technical payments.
 * Generating Medicare savings of approximately $200 million over 10 years.

“I’m proud to introduce the ROCR Act, which will provide a more stable and
sustainable payment framework for life-saving radiation oncology services,” said
Senator Tillis. “This legislation represents more than just the advancement of
meaningful value-based payment reform; it’s a promise to those battling cancer
that they’ll have uninterrupted access to high-quality care without facing
financial or geographic barriers.”

“The ROCR Act is a crucial step toward reforming our health care system to
better serve people with cancer,” said Rep. Fitzpatrick, co-chair of the House
Cancer Caucus. “By introducing this bill, we are standing up for Americans who
rely on radiation therapy as a lifeline during their most challenging times and
ensuring they have access to state-of-the-art treatment through a fair and
modernized payment system.”

“The current Medicare Part B payment system favors longer courses of cancer
treatment and undermines the ability of radiation oncology clinics to provide
tailored care,” said Rep. Panetta. “By creating a bundled payment system with
our bipartisan ROCR Act, we’ll more readily incentivize high-value treatment for
patients and potentially reduce the frequency of radiation sessions. We need to
ensure that Medicare is providing the best care possible for beneficiaries while
properly compensating providers in their work.”

“A cancer diagnosis is devastating for both a patient and their family, and no
patient receiving this life-altering news should be told that some treatments
are unavailable. Innovation is the bedrock of American medicine, and I’m proud
to join this bipartisan group to introduce the Radiation Oncology Case Rate
(ROCR) Act, which would help ensure that seniors have access to the innovative
and curative therapies that they need,” said Rep. Joyce.

“I've long been a believer in the tremendous value that radiation therapy
delivers for cancer patients and have worked for years to ensure fair and stable
payment that supports access to high quality care,” said Rep. Tonko. “The ROCR
Value-Based Care Act responds to the challenges facing our nation’s cancer
clinics and patients with a sound policy solution that supports better outcomes
and access across New York and America. I’m ready to work with my bipartisan
colleagues and the radiation oncology community to pass the ROCR Act this
Congress.”

Members of the radiation oncology community also continue to voice their
commitment to payment reform. Today, ASTRO shared a list of more than 40
healthcare institutions and organizations in support of ROCR including the
American Association of Physicists in Medicine, the American Association of
Medical Dosimetrists, the American College of Radiology, the US Oncology
Network, SERO (the Southeast Radiation Oncology Group), Providence health system
and the University of Michigan. Interested institutions can join this list here.

“Collaboration between policymakers and radiation oncology stakeholders will
continue to be essential to ensure the successful implementation of this
pioneering program and enhance the landscape of cancer treatment across
America,” said Dr. Michalski.

Radiation oncologists from across the country will travel to Washington, D.C.
next week to advocate for the ROCR Act as a solution to increase access and
reduce disparities in cancer care. As part of ASTRO’s Advocacy Day, more than 80
physicians representing 30 states will meet with members of Congress on Tuesday,
May 21.

ASTRO urges all members of Congress to support this bill and help usher in a new
era of evidence- and value-based policy solutions for cancer treatment.

ABOUT ASTRO

The American Society for Radiation Oncology (ASTRO) is the largest radiation
oncology society in the world, with more than 10,000 members who are physicians,
nurses, biologists, physicists, radiation therapists, dosimetrists and other
health care professionals who specialize in treating patients with radiation
therapies. Radiation therapy contributes to 40% of global cancer cures, and more
than a million Americans receive radiation treatments for cancer each year. For
information on radiation therapy, visit RTAnswers.org. To learn more about
ASTRO, visit our website and follow us on social media.


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