CMS proposed a rule to cancel cardiac and expanded joint replacement bundled payment models on Aug. 14 and a second rule to reduce the number of mandatory geographic areas reporting in the Comprehensive Care for Joint Replacement model on Aug. 15.
Here are five things to know:
1. CMS officials sent the rule proposed on Aug. 14 to the Office of Management and Budget last week, canceling the mandatory bundled payment program for heart attacks and bypass surgery as well as proposed expansion of CJR to cover hip and femur fractures that would have taken effect Jan. 1. CMS delayed the rule twice.
2. Physicians participating in the bundled payments would have the opportunity to receive a 5 percent bonus if CMS implements the bundles as planned; if they are canceled, the bonus would be eliminated.
3. The rule proposed on Aug. 15 would reduce the number of mandatory CJR reporting geographic areas from 67 to 34, and make participation in the 33 remaining areas voluntary. Participation would also be voluntary for all low volume and rural hospitals in the CJR geographic areas.
4. CMS expects to increase the opportunities for providers to participate in bundled payment initiatives on a voluntary basis instead of mandatory episode payments.
5. CMS Administrator Seema Verma said CMS designed these updates to allow the agency more time to test and evaluate models for improving quality and reducing costs. "Stakeholders have asked for more input on the design of these models," she said. "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."