CMS finalizes changes to bundled payment programs

CMS issued a final rule Thursday to officially cancel the hip fracture and cardiac bundled payment programs and rollback some mandatory requirements in the Comprehensive Care for Joint Replacement Model.

The move is part of the administration's goal to reduce mandatory alternative payment programs and offer more voluntary opportunities, according to CMS.

The final rule cancels the Episode Payment Models and the Cardiac Rehabilitation Incentive Payment Model, which would have started next year. It also finalizes changes to the CJR model that reduce mandatory requirements associated with the program. Under the final rule, hospitals in 33 of the 67 geographic areas selected to participate in CJR will no longer be required to participate, and low volume and rural hospitals across all 67 areas are also no longer required to participate.

In addition to the final rule, CMS also issued a related interim final rule with comment, seeking feedback on how to provide flexibility in determining the episode costs for hospitals affected by extreme circumstances, such as the hurricanes that hit Houston and Florida this year.

"While CMS continues to believe that bundled payment models offer opportunities to improve quality and care coordination while lowering spending, we believe that focusing on developing different bundled payment models and engaging more providers is the best way to drive health system change while minimizing burden and maintaining access to care. We anticipate announcing new voluntary payment bundles soon," CMS Administrator Seema Verma said in a press release.


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