CMS proposed rule would cancel three bundled payment models

The Centers for Medicare & Medicaid Services today issued a proposed rule that would cancel the cardiac and surgical hip and femur fracture treatment mandatory bundling payment programs, known as the episode payment models. It also would cancel the cardiac rehabilitation incentive payment model. These programs had been scheduled to begin Jan. 1, 2018. The rule also proposes to revise certain aspects of the Comprehensive Care for Joint Replacement model, including by giving certain hospitals selected for participation in the CJR model a one-time option to choose whether to continue their participation in the model. Specifically, the CJR model would continue on a mandatory basis in 34 of the 67 selected geographic areas, with an exception for low-volume and rural hospitals, and continue on a voluntary basis in the other 33 of 67 areas. “We previously expressed to CMS that we support bundled payment models as programs that could help transform care delivery through improved care coordination and financial accountability,” said Ashley Thompson, AHA senior vice president for public policy analysis and development. “We are concerned that a mandatory cancellation of the cardiac and SHFFT programs may be disruptive to providers who have expended valuable resources to put these programs in place.” AHA staff are reviewing the proposed rule closely and will seek member feedback.