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On May 15, 2024, Representatives Brian Fitzpatrick (PA-1), Jimmy Panetta (CA-19), John Joyce, M.D. (PA-13), and Paul Tonko (NY-20) introduced the bipartisan Radiation Oncology Case Rate (ROCR) Value-Based Program Act of 2024 in Washington, DC. The proposed legislation aims to modernize Medicare reimbursement for radiation therapy, thereby ensuring nationwide access to high-quality cancer treatments. The Act is expected to improve patient outcomes, reduce health disparities and generate savings for Medicare.

The ROCR program proposes a shift from Medicare’s current per-treatment payment system to a more patient-centered approach. This comes as shorter courses of radiation therapy are increasingly recommended in evidence-based clinical guidelines. However, the existing fee-for-service approach penalizes radiation oncologists for adhering to best practices in patient care.

Congressman Fitzpatrick emphasized that the ROCR Act represents a significant step towards reforming the healthcare system to better serve cancer patients. Congressman Panetta highlighted that the current Medicare Part B payment system undermines the ability of radiation oncology clinics to provide tailored care by favoring longer courses of treatment.

Congressman Joyce stressed that no patient should be told that some treatments are unavailable after receiving a life-altering cancer diagnosis. Congressman Tonko added that he has long advocated for fair and stable payments supporting access to high-quality care and believes the ROCR Value-Based Care Act offers a sound policy solution.

Jeff Michalski, MD, MBA, FASTRO, Chair of the American Society for Radiation Oncology (ASTRO) Board of Directors commended the bipartisan leadership in their fight against cancer through ROCR. He emphasized that this bill could ensure quality treatment remains accessible for all patients.

The ROCR also introduces an evidence-based approach to reducing disparities in cancer treatment through its Health Equity and Achievement in Radiation Therapy (HEART) initiative. Under HEART, centers would receive funds to support patients facing transportation barriers to accessing and completing their radiation treatments.

The ROCR also seeks to reverse the decade-long decline in Medicare payments for radiation therapy, which is prescribed to over a million Americans with cancer each year. Despite the significant value that radiation oncology delivers for patients and Medicare, reimbursements for radiation therapy have been cut by 23% over the past decade.

The ROCR builds on the strengths of the indefinitely-delayed Medicare-proposed Radiation Oncology Alternative Payment Model, particularly the use of episode-based payments. It also aims to address its shortcomings, including outsized payment cuts, burdensome quality requirements and the absence of mechanisms to reduce disparities.