CMS sought feedback on heart failure and pneumonia 30-day episode-of-care payment measures being developed by the Yale-New Haven Health Systems Corp. and Center for Outcomes Research and Evaluation. The measures would calculate risk-adjusted total payments for Medicare heart failure or pneumonia patient from hospital admission through 30 days post-discharge.
In a letter to CMS, AHA wrote that these measures would not accurately reflect hospitals’ performance on cost. Since the payment measures would also include payments for care after hospital discharge, they would reflect the care of multiple providers, not just hospitals, according to the AHA. “Attributing the results solely to one part of the system (i.e., hospitals) is unfair,” the letter stated.
AHA said the measures would be appropriate only in a bundled payment context.
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