ASTRO supports greater radiation oncology adoption of clinical guidelines supporting hypofractionation, but one-size-fits-all insurance company mandates are not the solution. Instead, ASTRO urges private payers to work with the Society to implement value-based care through alternative payment models (APMs).
"APMs are designed to be a better, smarter way of managing utilization. By paying a flat rate that bundles services, physicians are incentivized to provide the appropriate care, while allowing the physician to work with the patient to decide what is the most appropriate treatment. As Medicare moves to adopt a value-based model for radiation oncology, private insurers should look to implement a similar payment structure that could reduce costs while supporting high quality care for patients," said Dr. DeWeese.
Ad Statistics
Times Displayed: 112448
Times Visited: 6718 MIT labs, experts in Multi-Vendor component level repair of: MRI Coils, RF amplifiers, Gradient Amplifiers Contrast Media Injectors. System repairs, sub-assembly repairs, component level repairs, refurbish/calibrate. info@mitlabsusa.com/+1 (305) 470-8013
ASTRO previously called on radiation oncology benefits management companies to end restrictive coverage practices in the form of prior authorization requirements that create unnecessary delays and interfere in care decisions. In a 2019 survey of more than 700 radiation oncologists, nearly all (93%) said their patients experienced treatment delays, and a third said the average delay lasted more than five days. ASTRO is currently fielding a follow-up survey, and preliminary results suggest the problem of prior authorization has been exacerbated by the pandemic.
"Before COVID-19, ASTRO members said prior authorization was the biggest challenge they faced in daily practice," said Dr. DeWeese. "The new hypofractionation policy from eviCore is unfortunately another example of the health insurance industry subjugating physician judgement and removing patient choice from the cancer care process."
ASTRO supports the Improving Seniors Timely Access to Care Act (HR 3107), which has more than 230 bipartisan cosponsors in the House, as a critical first step to rein in excessive prior authorization practices.
ABOUT ASTRO
The American Society for Radiation Oncology (ASTRO) is the world’s largest radiation oncology society, 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. The Society is dedicated to improving patient care through professional education and training, support for clinical practice and health policy standards, advancement of science and research, and advocacy. ASTRO publishes three medical journals, International Journal of Radiation Oncology • Biology • Physics, Practical Radiation Oncology and Advances in Radiation Oncology; developed and maintains an extensive patient website, RT Answers; and created the nonprofit foundation Radiation Oncology Institute.
Back to HCB News
