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CMS again delays start of cardiac, ortho mandatory bundled payment models

Providers won’t have to worry about participating in a new set of mandatory Medicare episode payment models for cardiac and orthopedic procedures until next year.
January 1, 2018, now will mark the start of the performance year for the following programs:
  • A new episodic payment model for surgical treatment of hip and femur fractures,
  • Two separate episodic payment models for coronary artery bypass grafts and care of patients with acute myocardial infarction,
  • A new incentive payment program for cardiac rehab services and
  • Changes to the existing Comprehensive Care of Joint Replacement Procedures (CJR) program.
Based on 47 public comments CMS received to a March postponement of the mandatory bundled payment programs, CMS determined that an additional delay could help hospitals and their clinicians prepare for the programs and it “will ensure that CMS has adequate time to undertake notice and comment rulemaking if modifications are warranted,” the agency stated in the 16-page final rule.
HHS Secretary Tom Price, who signed the May 19 Federal Register posting, is a well-known opponent of these types of mandatory episode payment programs, in particular the CJR program, but CMS insisted in the rule that it isn’t ready to give up the ghost on them yet: “We disagree with commenters who suggested that CMS withdraw these models altogether and/or delay them indefinitely,” the rule states. “As we stated in the January 3, 2017 EPM final rule, we believe these models will further our goals of improving the efficiency and quality of care for Medicare beneficiaries receiving care for these common clinical conditions and procedures.”
Blog Tags: CMS, payment models
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