Update: Medicare Delays New Bundled Payment Models Until 2018

Update: The Centers for Medicare & Medicaid Services (CMS) has pushed back implementation of bundled payment programs for orthopedic surgery and cardiac care until Jan. 1, 2018.

CMS in March proposed the delay, which will ensure that “participants would have a clear understanding of the governing rules before episodes begin and have the opportunity to take additional steps to adjust to any potential changes that may be effectuated," CMS said.

The final rule can be found on the Federal Register.

Earlier: Medicare won't expand its bundled payment program for orthopedic surgery and won't start several similar programs for cardiac care until Oct. 1 — and maybe later — the Centers for Medicare & Medicaid Services (CMS) announced.

Those projects were initially slated to begin July 1. In the notice of the change, CMS asked for comments on further delaying those changes until Jan. 1, 2018.

Under the Comprehensive Care for Joint Replacement program, which began last year as a pilot project in 67 metropolitan areas, all related care for hip and knee replacements within 90 days of hospital discharge is included in the episode of care. CMS had planned to expand that program to include surgical hip and femur fracture treatment and recovery in those same 67 metropolitan areas.

The Acute Myocardial Infarction (AMI) Model and the Coronary Artery Bypass Graft (CABG) Model were set to begin July 1 in 98 metropolitan areas. The Cardiac Rehabilitation Incentive Payment Model, also initially expected to start July 1, would test financial incentives for the use of cardiac rehabilitation in 90 regions. 

Several media reports speculated that the delays might be a sign that Medicare bundled payment models might be on their way out.

"Prior to his confirmation, HHS Secretary Tom Price repeatedly expressed concerns about CMS' mandatory bundled payment programs," said Eric Cragun, senior director of health policy at the Advisory Board. "The latest announcement indicates that the Trump administration continues to review these programs, although their ultimate fate is still not certain."

Action, April 3, 2017

Last Updated On

May 19, 2017

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