数据表明，基于循证指南越来越多地使用大分割。过时的医疗保险按服务收费的方法会惩罚放射肿瘤学（RO）实践采用大分割，尽管许多患者受益。为了解决按服务付费的支付系统（该系统奖励数量多于价值）的问题，ASTRO 推出了放射肿瘤病例费率 (ROCR) 基于价值的支付计划。 ROCR 将 RO 服务的付费方式从按服务付费改为按患者或每次发作付费。为了解决差异问题，ROCR 通过放射治疗健康公平成就 (HEART) 计划提供循证方法，为服务不足的人群提供交通援助。此外，ROCR 允许实践足够的资金来维护现有设备并投资新技术。这增加了患者获得技术进步的机会，从而以更低的总体成本提供更高效、更有针对性和个性化的护理，并改善患者的治疗效果。版权所有 © 2024 Elsevier Inc. 保留所有权利。

Data demonstrates that hypofractionation is increasingly utilized based on evidence-based guidelines. The outdated Medicare fee-for-service approach penalizes radiation oncology (RO) practices from adopting hypofractionation, even as many patients benefit. To address the flawed fee-for-service payment system, which rewards volume over value, ASTRO introduced the Radiation Oncology Case Rate (ROCR) Value-Based Payment Program. ROCR shifts payment for RO services from fee-for-service to payment per patient or per episode. To address disparities, ROCR provides an evidence-based approach through the Health Equity Achievement in Radiation Therapy (HEART) initiative, providing transportation assistance payment for the underserved. Additionally, ROCR allows practices sufficient capital to maintain existing equipment and invest in new technology. This increases patient access to technological advancements allowing for more efficient, targeted, and personalized care with improved patient outcomes at a lower overall cost.Copyright © 2024 Elsevier Inc. All rights reserved.