HCB News: How did you first become involved with ASTRO?
JM: I joined ASTRO as a resident and have maintained my membership continuously ever since. Some of my first ASTRO activities were serving as a committee member on the Government Relations Committee, as well as the Finance and Audit Committees. I then was invited to co-chair the Emerging Technology Committee primarily because of my interests in innovative approaches to radiation treatment delivery.

HCB News: What are some of your key initiatives as ASTRO President and Chair?

JM: As has been the case in recent years, the specialty of radiation oncology continues to face challenges surrounding stable and fair reimbursement for services. While ASTRO has been a proponent of alternative payment models, attempts by the Centers for Medicare and Medicaid (CMS) to impose significant rate cuts and regulatory burdens under the guise of payment reform required our members to push back against these proposals. ASTRO is now seeking an alternative approach, the Radiation Oncology Case Rate (ROCR) model, that would move payments from per fraction to per patient, emphasizing reimbursement based upon episodes of care while discouraging over-utilization of services. There has been considerable feedback on this proposal, and we look forward to discussing it at greater length at the ASTRO Annual Meeting in San Diego.

ASTRO also wants to lessen the daily administrative burdens of prior authorization requirements we face with insurance companies and radiation oncology benefit managers. During our advocacy meetings on Capitol Hill, we have found support from many congressional stakeholders. We will continue to push for reforms that will end or lessen the frustrations that face physicians and patients alike.

Finally, the burgeoning field of theranostics requires the attention of radiation oncologists. New, disease-specific imaging agents and targeted therapeutics are re-imagining care for localized and oligometastatic disease. Having radiopharmaceuticals in our therapeutic armamentarium will expand opportunities for us to care for these patients. Practice models vary, both historically and geographically, but the role of the radiation oncologist in this therapeutic space should not be underestimated.

HCB News: What are some of the events or sessions you’re most looking forward to at this year’s Annual Meeting?
JM: This year’s Annual Meeting theme is focused on the primacy of clinical trials in the realm of evidence-based medicine and partnering with our patients through clinical trials. While real-world data may complement findings from clinical studies, phase three randomized trials are most often necessary to change clinical practice. In this year’s meeting, we will hear from patients who will share their experience in participating in clinical trials. I believe they will teach us valuable lessons in both the design of studies as well as the approach we use in the clinic when we offer them participation in research.

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