Bundled payment models: Will canceled surgeries affect the programs?

Participation in Medicare and commercial bundled payment models could be affected by guidance that urges hospitals to cease elective surgeries amid the COVID-19 outbreak, according to The National Law Review.

Nationwide, hundreds of hospitals and providers participate in inpatient episodes of care models. These include the Comprehensive Care for Joint Replacement Model and the Advanced Bundled Payments for Care Improvement Model. 

If providers can't provide the services tracked under these models, it could affect performance in the current model year, according to The National Law Review. It could also affect future years of the models, as target prices for episodes are based on historical claims.

On March 18, CMS Administrator Seema Verma urged all hospitals to comply with the American College of Surgeons' recommendation to cancel nonessential and non-urgent elective procedures. 

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