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CMS Cancels Some Bundled Payment Proposals

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CMS released a proposed rule that reduced the number of mandatory geographic areas for the joint bundled payment program and cancels the cardiac bundled payment program model.

In response to the cut, the American College of Cardiology released a statement indicating the ACC “will continue to work with CMS on opportunities for clinicians to participate meaningfully in Advanced Alternative Payment Models. As we move from volume-based care to value-based care, the path forward is challenging and we must work together to find solutions.”

The cardiac bundled program was set to begin in January 2018, but the bundled payment programs have been delayed multiple times. By eliminating the bundling programs, CMS also removes one of the ways providers can qualify for MACRA’s 5 percent advanced payment model bonus.

“Changing the scope of these models allows CMS to test and evaluate improvements in care processes that will improve quality, reduce costs, and ease burdens on hospitals,” said CMS Administrator Seema Verma. “Stakeholders have asked for more input on the design of these models. These changes make this possible and give CMS maximum flexibility to test other episode-based models that will bring about innovation and provide better care for Medicare beneficiaries.”

Moving forward, CMS expects to increase opportunities for providers to participate in voluntary initiatives rather than large mandatory episode payment model efforts, including additional voluntary episode-based payment models, the agency said.

The episode payment models and the cardiac rehab incentive models were designed as mandatory payment models to test the effects of bundling cardiac and orthopedic care beginning in 2018.

Read the proposed rule here