CMS Delays Bundled Payment Implementation, Expansion

Days may be numbered for controversial payment initiatives

A new interim rule released by the Centers for Medicare and Medicaid Services (CMS) has delayed the implementation and expansion of major bundled payment initiatives, according to a report from FierceHealthcare. The delay is welcome news to the Federation of American Hospitals and to the American Hospital Association, which have expressed concern about the accelerated pace of the program.

In the interim rule, posted to the Federal Register, the CMS:

  • Delays the implementation of the mandatory cardiac bundle program and cardiac rehabilitation program from July 1 to October 1.
  • Postpones the expansion of the mandatory joint-replacement bundle program to include other treatments for hip and femur fractures in addition to hip replacement from July 1 to October 1.
  • Further delays the effective date of a final rule to implement the joint-replacement bundle initiative, the cardiac rehabilitation incentive payment model, and the initiative to advance care coordination through episode payment models from March 21 to May 20.
  • Seeks comment on a potential further delay of the programs to January 1, 2018.

The latest delay calls the program’s future into question. Newly appointed Health and Human Services Secretary Dr. Tom Price has made it clear that he is not a fan of mandatory bundled payment initiatives. Last year, Price wrote a letter to the CMS, claiming that the agency overstepped its bounds by requiring bundled payments because they took the decision away from patients and physicians.

A final rule issued by the CMS in December 2016 held acute-care hospitals accountable for the quality and cost of care that Medicare patients receive during inpatient stays and 90 days after discharge for the treatment of a heart attack, bypass surgery, or a hip or femur procedure.

Sources: FierceHealthcare; March 21, 2017; and CMS; March 21, 2017.