What Are Hospitals Saying About The Proposed Cardiac Care Bundled Payment Rule?

The Medicare agency shouldn't force hospitals to participate in a cardiac care pilot program on top of other mandatory demonstration programs, industry groups recently told me.

Many hospitals are already subject to the Comprehensive Care for Joint Replacement (CJR) model for hip and knee replacements, and requiring some hospitals to also participate in the Cardiac Bundled Payment Model would create a big burden, Joanna Hiatt Kim, the American Hospital Association's vice president of payment policy, told me July 27.

The Centers for Medicare & Medicaid Services only started the joint replacement program in April and the agency should have given everyone more time to learn from that pilot before proposing a new one, Ivy Baer, a senior director and regulatory counsel at the Association of American Medical Colleges (AAMC), explained to me July 27.

Bundled payment models are one way the CMS is trying to reduce variations in treatment costs among hospitals while improving outcomes. With bundled payments, hospitals receive one payment for an entire episode of care that spans acute and post-acute care instead of receiving separate pay for individual services under the fee-for-service schedule.

Hospitals could face a financial downside for not coordinating follow-up care for heart attack and coronary bypass surgery patients under the cardiac model. The proposed rule (CMS-5519-P; RIN:0938-AS90) outlining the cardiac model was issued July 25, and will be published Aug. 2 in the Federal Register (143 HCDR, 7/26/16). Comments on the proposal are due 60 days after publication.

Read my full article for additional reaction to the proposal.

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