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Easing bundled payment requirements: A chance to accelerate value-based care

by Kyle Salem, Ph.D. on Sep 29, 2017

Last month, the Centers for Medicare & Medicaid Services (CMS) announced a proposed rule addressing bundled payment programs that have been, or are going to be, implemented by the Centers for Medicare & Medicaid Innovation (The CMS Innovation Center)—a department established by the Affordable Care Act to serve as a test bed for value-based care initiatives.

In the proposed rule, CMS substantially decreases several bundled payment programs, including the Comprehensive Care for Joint Replacement (CJR) Model—making the program mandatory for only 34 geographic areas instead of the 67 that were previously required. The remaining areas will have the option to opt in or opt out of the program. In addition, the Episode Payment and Cardiac Rehabilitation Incentive payment models, which were due to begin this coming January, were cancelled. Note that CMS did not alter the Bundled Payments for Care Improvement Initiative (BPCI), which is the largest bundled payment program and is scheduled to run through September 2018. It is possible that some of the previously mentioned models could be rolled under the BPCI course.

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Meet the Author

Kyle Salem earned his doctorate in biomedical engineering from Case Western Reserve University and has completed the Kellogg Management Institute at the Kellogg School of Management at Northwestern University. Kyle worked for Siemens Medical Solutions MRI Research & Development division, serving as the primary scientist supporting its second 3 Tesla MRI scanner in the U.S. He also managed U.S. R&D Collaborations for MRI for two years. In 2005, Kyle joined Cassling Diagnostic Imaging, where he held a number of roles from strategic sales executive through vice president of Corporate Strategy and Development. It was during this time that he learned about the considerable challenges of managing health care, and was able to focus on how industry could strengthen community health care by lowering cost and increasing quality and efficiency. Kyle is passionate about the future model of care coordination, payment reform and new technologies in health-care delivery.

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