RO APM may be implemented this year

This forum made possible through the generous support of SDN members, donors, and sponsors. Thank you.
Gfunk6

Gfunk6

And to think . . . I hesitated
Moderator Emeritus
Lifetime Donor
Verified Member
Physician
Faculty
PhD
Verified Expert
20+ Year Member
Gold Donor
Joined
Apr 16, 2004
Messages
4,660
Reaction score
5,074
ASTRO held a stakeholder call yesterday. It looks like CMS wants to publish the APM final rule by March and implement.by July 2020. Details will be forthcoming soon but it sounds like they have been seriously considering some APM recommendations submitted by ASTRO.
Members don't see this ad.
 
Would love to hear that UAB resident's opinion on this. As far as I am concerned the "real stakeholders" are this years match class who have been lied to.
 
  • Like
Reactions: 1 users
Members don't see this ad :)
I can confirm that this exact same timeline was provided to me by another entity about a month ago. I still have some doubts though that it will go live on this timeline based on how the government operationalizes changes in policy like this and things that have not yet done. But we'll see.
 
RickyScott said:
Would love to hear that UAB resident's opinion on this. As far as I am concerned the "real stakeholders" are this years match class who have been lied to.
Click to expand...

His Twitter account is littered with virtue-signalling Medicare-for-all, bernie bro, and Eugene Gu re-tweets. So, I would say you can probably guess and would be right.
 
  • Like
Reactions: 2 users
Oh dear. Dr. Gu is not someone anyone should want to be associated with. Good lord. Whatever your politics, and mine are diametrically opposed to our RROM (Rural Rad Onc Millionaire), Gu is a woman hating (beating?) unlicensed physician with some extremist views and dangerous thinking.
 
Last edited by a moderator:
ROFallingDown said:
Oh dear. Dr. Gu is not someone anyone should want to be associated with. Good lord. Whatever your politics, and mine are diametrically opposed to our RROM (Rural Rad Onc Millionaire), Gu is a woman hating (beating?) unlicensed physician with some extremist views and dangerous thinking.
Click to expand...

Be careful, you don't want to get sued!

Dr. Gu is a humble, compassionate physician. Great guy! Please don't sue me!!!
 
  • Haha
Reactions: 1 users
KHE88 said:
His Twitter account is littered with virtue-signalling Medicare-for-all, bernie bro, and Eugene Gu re-tweets. So, I would say you can probably guess and would be right.
Click to expand...
Medicare for all, would result in the shut down of so many “duplicate” ,competing,redundant centers in many locations? Hard to reconcile being a fan of Medicare for all and workforce expansion? ( Disclaimer- I actually believe health care is a basic right for us residents)
 
Last edited:
Members don't see this ad :)
The mandatory aspect of it is disturbing and should continue to be questioned and fought.

Site neutrality of the APM while people cheer it I still don’t understand it as many freestanding facilities have been bought or died out. What exactly can you compare it to if they don’t exist.

If a hospital is in over multiple zip codes how does CMS select hospitals. It would be awkward to have the same hospital on 2 different payment schemes.

Fixed payment means probably that the midcareer guys will suck it up and just burn through more patients to compensate. They won’t hire anyone. Hospitals will likely follow in their footsteps. I just do see this helping the job market much at all.
 
  • Like
Reactions: 2 users
^^ I believe most are in agreement that APM would lead to a further decline in the job market and the hiring of new radiation oncologists.

That's certainly my thought process, especially in combination with CMS rules on supervision.

Physicians can see more patients if they don't have to do P2P for everything they want to do. More patients seen per physician = less need for additional physicians, extenders, etc.
 
evilbooyaa said:
^^ I believe most are in agreement that APM would lead to a further decline in the job market and the hiring of new radiation oncologists.

That's certainly my thought process, especially in combination with CMS rules on supervision.
Click to expand...

Basically you’ll get practices that won’t hire. They’ve also tried this new thing we’re in your contract they now reserve the right to proactively alter your compensation based on if CMS changes . If you signed contract for 350 and they’re only getting enough collections from medicare for 275. You could end up owing the hospital as a result.


They should at the very least fight for an extension until the implications can be worked out.

And yet these blind and dumb medical students should keep getting churned out. What a sham.
 
Last edited by a moderator:
RadsWFA1900 said:
The mandatory aspect of it is disturbing and should continue to be questioned and fought.

Site neutrality of the APM while people cheer it I still don’t understand it as many freestanding facilities have been bought or died out. What exactly can you compare it to if they don’t exist.

If a hospital is in over multiple zip codes how does CMS select hospitals. It would be awkward to have the same hospital on 2 different payment schemes.

Fixed payment means probably that the midcareer guys will suck it up and just burn through more patients to compensate. They won’t hire anyone. Hospitals will likely follow in their footsteps. I just do see this helping the job market much at all.
Click to expand...

Midcareer guy. All my partners locally (7 of them) are midcareer, save one guy. When he retires, we do not plan on replacing him. We also do not plan on hiring anyone for a good decade.
 
  • Like
  • Sad
  • Wow
Reactions: 4 users
That is good business and I’m sure many strong practices will do the same.
 
  • Haha
Reactions: 1 user
OTN said:
Midcareer guy. All my partners locally (7 of them) are midcareer, save one guy. When he retires, we do not plan on replacing him. We also do not plan on hiring anyone for a good decade.
Click to expand...

It really makes no damn sense to do so.

They should have also planned on canning residencies as well but ofcourse being the greedy Little ****s that they are in academia nobody looks out for hapless residents.

If we weren’t so polite, so many people would be hanging from the rafters right now.
 
Last edited by a moderator:
OTN said:
Midcareer guy. All my partners locally (7 of them) are midcareer, save one guy. When he retires, we do not plan on replacing him. We also do not plan on hiring anyone for a good decade.
Click to expand...
what if a resident “networked”- would this compel you to generate a job where none existed?
 
  • Haha
  • Like
Reactions: 8 users
What does this mean for students? I am trying to decide between rad onc and diagnostic rads but the negative outlook here has me worried. Is the result of this graduates in 5 years not having jobs or taking lower compensation?
 
Please discuss, this is a topic that hasn’t come up yet on the forum ...
 
  • Haha
Reactions: 1 users
Ask Jeeves MD said:
What does this mean for students? I am trying to decide between rad onc and diagnostic rads but the negative outlook here has me worried. Is the result of this graduates in 5 years not having jobs or taking lower compensation?
Click to expand...

get out now....
 
Ask Jeeves MD said:
What does this mean for students? I am trying to decide between rad onc and diagnostic rads but the negative outlook here has me worried. Is the result of this graduates in 5 years not having jobs or taking lower compensation?
Click to expand...

Please read literally the rest of the forum. Get some popcorn.

A TL;DR, is yes, there is concern about under or unemployment, especially in the future. Whether that will happen or not will depend on a multitude of factors currently out of folks' control, and while (IMO) likely, will also depend on a potential response to the issues currently at hand.
 
Ask Jeeves MD said:
What does this mean for students? I am trying to decide between rad onc and diagnostic rads but the negative outlook here has me worried. Is the result of this graduates in 5 years not having jobs or taking lower compensation?
Click to expand...

Dude why are you bothering here. Think about it how many specialties are joyfully participating in their own demise? Rad onc. DR is still needed AI isn’t all it’s cracked up to be and theresteady work even with the “image wisely” BS. DRs can work almost anywhere and can do well.

If you want to throw away your education on 5 years of this crap only to be told you didn’t network enough the by all means do it. You really are taking a risk here.

Every specialty becomes a job just make sure it doesn’t become a ****ty one
 
  • Like
Reactions: 1 user
Haha, fair enough. Thanks for the replies.

I really liked the patients and radiation is the coolest medicine I've seen just a bummer the field is in such bad shape.
 
Last edited:
  • Like
Reactions: 3 users
Ask Jeeves MD said:
What does this mean for students? I am trying to decide between rad onc and diagnostic rads but the negative outlook here has me worried. Is the result of this graduates in 5 years not having jobs or taking lower compensation?
Click to expand...

100% stay away from rad onc. Job market is terrible now and circling the drain.
 
  • Haha
Reactions: 1 user
The monthly ‘we all feel bad/sad for Duke’ sentiment
 
  • Sad
Reactions: 1 user
Ask Jeeves MD said:
Haha, fair enough. Thanks for the replies.

I really liked the patients and radiation is the coolest medicine I've seen just a bummer the field is in such bad shape.
Click to expand...

This field is not unique in the direction it's taking.

Path went down this same road and is a few years ahead of it.

DR had an issue like this but has rebounded due to increasing utilization.

EM seems to be on the same road but a few years behind us based on lurking in their forum.

If you're OK with being a med-onc, I would go that route instead currently. Their road (while it may change in the future) is looking good right now.]

If you can't imagine being nothing else but a Rad Onc, then go ahead and apply rad onc and get into the best residency in the region you want to live in that you can.
 
  • Like
Reactions: 2 users
the psychological impact of apm on hiring if it’s implemented in its current form will be like what Coronavirus is doing to stock market.
 
On that note, (and mods feel free to move this to a separate topic if you like), what steps if any are people and their clinics taking for this whole coronavirus thing? Apart from stocking up on corona, of course
 
I'm trying to r/s 3 of my prostate implants, to do them next week. I have a feeling that hospitals and public school closures are coming.
 
  • Sad
Reactions: 1 user
taserlaser said:
On that note, (and mods feel free to move this to a separate topic if you like), what steps if any are people and their clinics taking for this whole coronavirus thing? Apart from stocking up on corona, of course
Click to expand...

Investing my entire paycheck in the S&P 500 every 2 weeks.

I have a feeling this is going to get a lot uglier very quickly.
 
Looks like Azar has found himself in Trump's crosshairs... if he is out, possible reprieve for us in radiation oncology?
 
Pointless said:
Looks like Azar has found himself in Trump's crosshairs... if he is out, possible reprieve for us in radiation oncology?
Click to expand...

Doubt it. Cancer care costs too much, and Medicare patients have a lot of cancer. Rad onc is just a portion of it sure, but taking us out of the picture for a second, even the Oncology Care Model is too far along now for anyone to stop it, imo
 
PhotonBomb said:
Doubt it. Cancer care costs too much, and Medicare patients have a lot of cancer. Rad onc is just a portion of it sure, but taking us out of the picture for a second, even the Oncology Care Model is too far along now for anyone to stop it, imo
Click to expand...
Medicare just shoveled out to cash to anyone who billed Medicare last year, federal reserve/central bank style because of how much covid affected some practices. Won't see APM until at least 2022, I'm guessing. If that. Very good possibility APM dies with the next administration's HHS head.
 
Last edited:
  • Like
Reactions: 1 user
medgator said:
Medicare just shoveled out to cash to anyone who billed Medicare last year, federal reserve/central bank style because of how much covid affected some practices. Won't see APM until at least 2022, I'm guessing. If that
Click to expand...
I agree with this. The current environment with COVID plus the anticipated removal of the architect of APM means we shouldn't see meaningful cuts for at least a few more years. Just trying to find a silver lining in all of this...
 
Pointless said:
I agree with this. The current environment with COVID plus the anticipated removal of the architect of APM means we shouldn't see meaningful cuts for at least a few more years. Just trying to find a silver lining in all of this...
Click to expand...

Sure a reprieve but facts haven’t changed for after the short term
 
  • Like
Reactions: 1 user
If Biden wins, I think he is unlikely to support gutting oncology to save some money... I’m guessing he would look long and hard at the Defense Department first (which is one industry in America that is even more bloated than healthcare)
 
  • Like
Reactions: 1 users
Lamount said:
If Biden wins, I think he is unlikely to support gutting oncology to save some money... I’m guessing he would look long and hard at the Defense Department first (which is one industry in America that is even more bloated than healthcare)
Click to expand...

Biden will do whatever Tara Reade tells
Him to
 
You must log in or register to reply here.
Next unread thread

Similar threads

C
RO APM indefinitely postponed...ASTRO still wants to politic
2
Replies
78
Views
3K
NotMattSpraker
N
C
RO APM conspiracy theories
Replies
7
Views
1K
TheWallnerus
TheWallnerus
elementaryschooleconomics
RO-APM Podcast Episode (from The Accelerators)
6 7 8 9 10
Replies
451
Views
24K
Jaguaranna27
Jaguaranna27
R
Sbrt may speed up Mets?l
Replies
21
Views
1K
SneakyBooger
SneakyBooger
D
RO APM Dies!
9 10 11 12 13
Replies
636
Views
45K
medgator
M
Top