Topics
More on Reimbursement

CMS finalizes rule canceling mandatory bundled payment models

CMS Administrator Seema Verma said the agency will announce new voluntary payment bundles soon.

Susan Morse, Senior Editor

CMS Administrator Seema Verma speaking at the Nov. 8 NAMD event. Credit: <a href="https://www.youtube.com/watch?v=CuWevnFtsQE" target="_blank">YouTube</a>CMS Administrator Seema Verma speaking at the Nov. 8 NAMD event. Credit: YouTube

In a final rule released Thursday, the Centers for Medicare and Medicaid Services is following through on its proposal to cancel hip fracture and cardiac bundled payment models.

CMS has also scaled back the number of geographic areas participating in the comprehensive care for joint replacement model.

[Also: CMS says it will change direction of CMMI, wants providers to have greater flexibility in payment model design]

Both rule changes have been expected, as CMS under the Trump Administration has opposed mandatory participation in bundled payments.

CMS Administrator Seema Verma said the agency anticipated announcing new voluntary payment bundles soon.

[Also: Trump HHS pick Tom Price decries government mandates from CMMI, reporting burdens during hearing]

On Thursday, CMS officially cancelled the episode payment models and the cardiac rehabilitation incentive payment model that came out of the CMS Innovation Center under the previous administration. They were scheduled to start on January 1, 2018. 

CMS reduced the number of mandatory geographic regions participating in comprehensive care for joint replacement model from 67 to 34 areas. CMS is also making participation voluntary for all low volume and rural hospitals in the 67 geographic areas.

[Also: AHA tells Seema Verma to decrease regulatory burden in redesigning CMMI]

CMS is seeking comment on a final policy in determining episode cost for hospitals in those areas impacted by major hurricanes in 2017.

"While CMS continues to believe that bundled payment models offer opportunities to improve quality and care coordination while lowering spending, we believe that focusing on developing different bundled payment models and engaging more providers is the best way to drive health system change while minimizing burden and maintaining access to care," Verma said.

Not pursuing these models gives CMS greater flexibility to design and test innovations that will improve quality and care coordination across the inpatient and post-acute care spectrum, CMS said.

Earlier this fall, CMS asked for stakeholder comment on how to proceed with new models out of the Center for Medicare and Medicaid Innovation.

Moving forward, CMS said it expects to increase opportunities for providers to participate in voluntary initiatives rather than large mandatory bundled payment models.

Twitter: @SusanJMorse
Email the writer: susan.morse@himssmedia.com

Show All Comments