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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Beckers Hospital Review CFO Report