The Trump administration has postponed the debut of four new payment models that appear to conflict with the health care philosophy of new HHS Secretary Tom Price.
A final rule released on Jan. 3 implemented three new Medicare episode payment models (EPMs) and a Cardiac Rehabilitation (CR) Incentive Payment model, as well as made changes to the existing Comprehensive Care for Joint Replacement (CJR) model (PBN 1/2/17). The new EPMs would require hospitals in certain geographic areas to be paid for treatment of myocardial infarction, coronary artery bypass graft and surgical hip/femur fractures as well as 90 days of post-discharge care on an episodic basis; the CR incentive payment model would do the same for cardiac rehab in a 90-day post-discharge period.
The new programs, and the changes to the CJR program, were set to start on July 1, but a new interim final rule issued by HHS on March 20, delays them until Oct. 1, pending comments.
“This additional three-month delay is necessary to allow time for additional review, to ensure that the agency has adequate time to undertake notice and comment rulemaking to modify the policy if modifications are warranted,” says the rule. CMS seeks comment on the possibility of “a longer delay” on these models, possibly to Jan. 1, 2018.
Price has a long record of opposition to episodic payment models such as CMS’ bundled payment model for hip and knee replacements – an opposition that drew fire during his hearings when some accused him of a sweetheart deal with Zimmer Biomet, a manufacturer of knee- and hip-replacement parts (PBN 1/18/17, 12/15/16).