ROCR / Beckta Podcast

[winstonfoot5]

I would love a blog post with supporting Tables/Figures and original source citations/references detailing the 21C-ASTRO-CMS-Department of Justice histories including highlighting the key players and COIs of the cast of characters (Wallner, Mantz, Dosoretz, etc).

btw, the purpose being not necessarily so much about the individuals, although rad onc certainly has no shortage of interesting characters, but really to question if ASTRO serves its membership (much less, all of rad onc, or "gasp" our patients) at large, versus an influential subset/sub-special interest group.

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[NotJasonBeckta]

Great post.
I listened to the pod - Its a magnificent effort. It shows how just how deep the rot of this specialty goes.
I wish a lot of the material on the podcasts and this forum were packaged in concise blog format preserved for posterity. Both podcasts and this forum somehow paradoxically become an inaccessible morass - Difficult to search and often hard to separate the signal from the noise.
I would love a blog post with supporting Tables/Figures and original source citations/references detailing the 21C-ASTRO-CMS-Department of Justice histories including highlighting the key players and COIs of the cast of characters (Wallner, Mantz, Dosoretz, etc).
The boomers have sucked the marrow out of this specialty. Im more and more convinced its only hope at salvation is being folded back under the house of Radiology.

I stole a page out of the "Malcontent's Playbook" (authors: @RealSimulD and @NotMattSpraker) and made this non-anonymous account.

First, I appreciate everyone's feedback. SDN is one of the most important resources in modern Radiation Oncology. It's very strange to see my name on a thread - I'm flattered.

As everyone has put together, this was an insane amount of information. I genuinely didn't know how to approach this in the beginning.

I knew doing a single episode with all the details would be >4 or 5 hours at minimum, and that wasn't reasonable. At the same time, I knew that almost no one else knew about this stuff, and it wasn't something that I was morally/ethically OK with keeping secret.

I also didn't want to do a "slow drip" episode series and be accused of "milking it" or whatnot. I can see my analytics, and know these things get passed around, and I know the "right people" will hear this if it's self-contained, whereas they might not if it's a 10-episode saga.

Even though I'm the one who made it, when I went back and listened to it myself, I was overwhelmed at the density. AND I'M THE ONE WHO MADE IT.

So, now that the bones of this is out in the universe, I do plan on revisiting all if it, in digestible chunks, with a blog/website thing. That already half exists actually, but not ready for primetime.

Along the "things that half exist", Cold Light really exists, it really is a 501c3 nonprofit, and it really is meant to champion radiotherapy in ways that have not been done previously.

Basically: as long as I'm breathing, I will be working towards a world where we're not some secretive freaks yelling at each other in a damp corner of the hospital while the government slashes our reimbursement to zero.

www.coldlight.org

 

[BobbyHeenan]

I stole a page out of the "Malcontent's Playbook" (authors: @RealSimulD and @NotMattSpraker) and made this non-anonymous account.

First, I appreciate everyone's feedback. SDN is one of the most important resources in modern Radiation Oncology. It's very strange to see my name on a thread - I'm flattered.

As everyone has put together, this was an insane amount of information. I genuinely didn't know how to approach this in the beginning.

I knew doing a single episode with all the details would be >4 or 5 hours at minimum, and that wasn't reasonable. At the same time, I knew that almost no one else knew about this stuff, and it wasn't something that I was morally/ethically OK with keeping secret.

I also didn't want to do a "slow drip" episode series and be accused of "milking it" or whatnot. I can see my analytics, and know these things get passed around, and I know the "right people" will hear this if it's self-contained, whereas they might not if it's a 10-episode saga.

Even though I'm the one who made it, when I went back and listened to it myself, I was overwhelmed at the density. AND I'M THE ONE WHO MADE IT.

So, now that the bones of this is out in the universe, I do plan on revisiting all if it, in digestible chunks, with a blog/website thing. That already half exists actually, but not ready for primetime.

Along the "things that half exist", Cold Light really exists, it really is a 501c3 nonprofit, and it really is meant to champion radiotherapy in ways that have not been done previously.

Basically: as long as I'm breathing, I will be working towards a world where we're not some secretive freaks yelling at each other in a damp corner of the hospital while the government slashes our reimbursement to zero.

www.coldlight.org

love it!

༼ つ ◕_◕ ༽つ TAKE MY ENERGY ༼ つ ◕_◕ ༽つ

 

[winstonfoot5]

I knew that almost no one else knew about this stuff

Would be interesting to engage the inner circle in this conversation somehow, although they basically have zero incentive to respond at all. but a follow up interview with Manz or Wallner or Dosoretz (or take your pick boomer grad from the Top 3) would be amazing

 

[NotMattSpraker]

I laughed out loud when I saw we are getting another go around at a policy town hall this year

I wonder if this one will be real.

I am not affiliated with this in any way, but it seems very interesting and I hope policy forward Rad Oncs join. Its super interesting they met with CMMI and I think the survey was very interesting. I have personally been wondering the field's thoughts about many questions asked in their survey.

 

[sirspamalot]

Big D "Red Light" Boi likes to hear himself talk, but he is still less nauseating than the one he replaced.

Eventually new blood will take over ACRO and it will hopefully grow and prosper even more, if for no other reason, well.. because.. you know.

FASTRO?

No! ...

 

[evilbooyaa]

I laughed out loud when I saw we are getting another go around at a policy town hall this year

I wonder if this one will be real.

I am not affiliated with this in any way, but it seems very interesting and I hope policy forward Rad Oncs join. Its super interesting they met with CMMI and I think the survey was very interesting. I have personally been wondering the field's thoughts about many questions asked in their survey.

View attachment 378632

I have more hope that this will be an actual discussion (although TBD), but does ACRO have any sway with ASTRO to actually change any of their thoughts when it comes to ROCR? Or are they are powerless as SDN just shouting into the void?

 

[deleted1111261]

All it takes to kill it is enough phone calls and e-mails

There will be an equal or more amount opposing it. And so it won’t go through

They have no idea what a lift this is

 

[BobbyHeenan]

My apologies if I missed it or if this is in the wrong thread....

the ROCR is not indexed to inflation, correct? It is just asking for stable case based payments, right?

I want NOTHING to do with anything locking us into some rate....inflation could continue to skyrocket and here we would sit locked into rates . yes, I understand we are already not indexed to inflation but other organizations are starting to push for that. It needs to be a priority IMO.

 

[evilbooyaa]

My apologies if I missed it or if this is in the wrong thread....

the ROCR is not indexed to inflation, correct? It is just asking for stable case based payments, right?

I want NOTHING to do with anything locking us into some rate....inflation could continue to skyrocket and here we would sit locked into rates . yes, I understand we are already not indexed to inflation but other organizations are starting to push for that. It needs to be a priority IMO.

I believe it does push for increases with inflation. But there are proposals out by the AMA to simply index the entirety of the CMS pie to inflation without forcing case-based repayment picking winners (protons, adaptive, brachy) and losers (not those things) that have been linked on this forum before.

But, this is ASTRO's *best* version of it. What will (if it does) get passed will likely *NOT* be ROCR the way ASTRO wants, but a more CMS friendly version.

We (hopefully) all remember when CMS came out with RO-APM, ASTRO had all these thoughts, and then CMS was like "nah, go **** yourselves, we're not incorporating any of that". Now maybe those CMS heads have rolled or golden parachuted out (I'm actually ignorant on this, so would love a fact check), but I presume those next in line at CMS is going to be similar to ASTRO in at least one mindset:
"Meet the new boss, same as the old boss"

 

[NotMattSpraker]

I believe it does push for increases with inflation. But there are proposals out by the AMA to simply index the entirety of the CMS pie to inflation without forcing case-based repayment picking winners (protons, adaptive, brachy) and losers (not those things) that have been linked on this forum before.

But, this is ASTRO's *best* version of it. What will (if it does) get passed will likely *NOT* be ROCR the way ASTRO wants, but a more CMS friendly version.

We (hopefully) all remember when CMS came out with RO-APM, ASTRO had all these thoughts, and then CMS was like "nah, go **** yourselves, we're not incorporating any of that". Now maybe those CMS heads have rolled or golden parachuted out (I'm actually ignorant on this, so would love a fact check), but I presume those next in line at CMS is going to be similar to ASTRO in at least one mindset:
"Meet the new boss, same as the old boss"

ROCR is a legislative proposal, outside CMS/CMMI. This is why I am super interested in ACRO's "meeting with CMMI" that they will talk about on their town hall.