RO APM Dies!

[TheWallnerus]

It has been said that the RO APM is suspected dead. A new proposed rule which appeared in office of budget and management might suggest it is a cancellation before it is made public. Need to follow this folks but yuge if true.

Will it be dead like PORT in N2 lung is dead or dead like Ethyol in rad onc is dead. That is the question. Either way don’t f*** with the proton gang they will shiv you.

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[jondunn]

Will it be dead like PORT in N2 lung is dead or dead like Ethyol in rad onc is dead. That is the question. Either way don’t f*** with the proton gang they will shiv you.

From what I hear, some community rad oncs are so happy they’re even considering sending some kids to proton!

Considering.

 

[thecarbonionangle]

Will it be dead like PORT in N2 lung is dead or dead like Ethyol in rad onc is dead. That is the question. Either way don’t f*** with the proton gang they will shiv you.

Dead like a tailess rigor mortis possum on side of road in the heat of Georgia. If you talked to a proton person they assured you an exception or death of APM was a sure thing, despite signs of the contrary at the time. At that time, this was either proton arrogance or they knew something. Turns out proton lobby is very very powerful and saved the field. The fix was in all along. So the real question is Does anybody love protons more than community rad onc now?

 

[deleted1111261]

This is really quite a storyline

Other than hearsay from noCal, any corroboration ?

 

[thecarbonionangle]

This is really quite a storyline

Other than hearsay from noCal, any corroboration ?

Nobody will ever be able to tell you how the sausage was made,exactly. What you know is you like the sausage so you dont care how it was made.

 

[communitydoc13]

So the real question is Does anybody love protons more than community rad onc now?

Dammit

 

[Lamount]

Will it be dead like PORT in N2 lung is dead or dead like Ethyol in rad onc is dead. That is the question. Either way don’t f*** with the proton gang they will shiv you.

Not to beat a dead horse, but PORT is certainly not dead everywhere.

If you have 50%+ LN positivity, or ECE in my tumor board, you’re probably going to get (offered) PORT

 

[Lamount]

Dead like a tailess rigor mortis possum on side of road in the heat of Georgia. If you talked to a proton person they assured you an exception or death of APM was a sure thing, despite signs of the contrary at the time. At that time, this was either proton arrogance or they knew something. Turns out proton lobby is very very powerful and saved the field. The fix was in all along. So the real question is Does anybody love protons more than community rad onc now?

 

[Chartreuse Wombat]

From ASTRO Blog

 

[thecarbonionangle]

From ASTRO Blog

View attachment 351529

If its what you say—I LOVE IT!

 

[metallica81788]

 

[TheWallnerus]

The PET scan on APM looked totally negative in November after CMS gave it some SBRT. Now it’s metting out everywhere. It’s been in hospice and the family is calling the chaplain today. Thoughts and prayers.

 

[Mandelin Rain]

New title suggestion: RO APM Dies!

 

[Mandelin Rain]

I'd like to take this opportunity to give a impassioned FU to Alex Azar.

 

[deleted941485]

I'd like to take this opportunity to give a impassioned FU to Alex Azar.

Alex Azar the drugstore cowboy! Alex blame the high cost of HC on Rad Onc Azar.

Guess he will just have to go back to lobbying full time preventing Medicare from negotiating drug prices LOL.

 

[Burt Radnolds]

So I should cancel my Brocade order?

 

[elementaryschooleconomics]

Ah, so much time and energy from thousands of people have gone into examining and/or preparing for this model for years. Effort that could have gone into, perhaps, patient care?

Are we really anything but hamsters running frantically on a wheel, our white coats gallantly flapping in the breeze, giving everything we have to tasks which ultimately lead nowhere?

 

[deleted941485]

Ah, so much time and energy from thousands of people have gone into examining and/or preparing for this model for years. Effort that could have gone into, perhaps, patient care?

Are we really anything but hamsters running frantically on a wheel, our white coats gallantly flapping in the breeze, giving everything we have to tasks which ultimately lead nowhere?

View attachment 351574

Seems to be the hallmark of academic rad onc at the moment. It’s no surprise the halls of govt work in a similar fashion

While we are on the topic. Think if the thousands or hundreds of thousands of wasted human labor hours among med students, residents, attendings, support staff churning out meaningless paper after paper all for the purpose of padding a CV or getting a letter of rec. i mean I would assume these people could have been doing something more creative prospective taking risks furthering out modality right? Maybe I’m wrong.

 

[thesauce]

Any further word on whether APM is dead?

 

[ramsesthenice]

Are we really anything but hamsters running frantically on a wheel
View attachment 351574

Depends on what you mean by “we.” The residents and med students doing the doing, maybe. The folks at the top gorging on other peoples desperation…they don’t do much running these days

 

[thecarbonionangle]

Depends on what you mean by “we.” The residents and med students doing the doing, maybe. The folks at the top gorging on other peoples desperation…they don’t do much running these days

View attachment 352760

Is that a pic of my chair?

 

[deleted941485]

Is that a pic of my chair?

Chair? My current boss has the same proportions as well.

 

[RadOncDoc21]

Fat cats (and dogs) got to eat!

 

[radoncle]

Any further word on whether APM is dead?

I was wondering the same. Any updates?

 

[TheWallnerus]

I was wondering the same. Any updates?

I think we will get an update on the death of APM like authors give updates when the negative results of a phase 1 study will be published

 

[deleted1111261]

It’s dead. Don’t worry about it for now!

 

[ramsesthenice]

I think we will get an update on the death of APM like authors give updates when the negative results of a phase 1 study will be published

 

[Chartreuse Wombat]

 

[deleted1111261]

What does this mean?

 

[thecarbonionangle]

What does this mean?

She just posted again and said APM is delayed but not dead yet so the uncertainty continues

 

[Burt Radnolds]

 

[CptCrunch]

Federal Register :: Request Access

Skimmed it briefly, just says they propose a delayed start and to define a start date instead of delaying indefinitely.

 

[ramsesthenice]

Santa Clause. The Easter Bunny. RO APM. Voluntary price cuts on proton therapy. I hate to disappoint anyone, but none of these are or ever will be real. Despite what the supposed “grown ups” in your life want you to think.

 

[elementaryschooleconomics]

 

[GapCalc]

ASTRO:

"The Centers for Medicare and Medicaid Services today delayed the Radiation Oncology Alternative Payment Model start date from January 1, 2023, to a date to be determined through future rulemaking. ASTRO remains hopeful that during this process, CMS also makes the adjustments recommended by Congress and the broad coalition of stakeholders within the radiation oncology community as we remain concerned that the model in its current form is too punitive for clinics. We remain committed to value-based care in radiation oncology. We believe that the modifications proposed by ASTRO and the radiation oncology community will ensure successful participation among physicians and facilities and produce significant savings for the Medicare program. We continue to believe that episodic payments for radiation therapy services have great potential to improve quality and equity while reducing cancer care costs, and we will continue to advocate for proposals that achieve these goals.”

 

[deleted1111261]

ASTRO:

Gobbledygook

 

[medgator]

Delayed indefinitely per the email in my inbox tonight