CMS canceled the mandatory hip fracture and cardiac bundled payments scheduled to go into effect Jan. 1, 2018, and made changes to the Comprehensive Care for Joint Replacement Model with the goal of offering more flexibility.
"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," said CMS Administrator Seema Verma. "We anticipate announcing new voluntary payment bundles soon."
Here are five things to know:
1. CMS reduced the number of geographic areas participating in CJR on a mandatory basis from 67 to 34.
2. As of Feb. 1, 2018, CJR will not be mandatory for low-volume hospitals — those with fewer than 20 CJR episodes in total over the past three years — or rural hospitals in the covered geographies. However, rural hospitals can choose to participate if they comply with CJR regulations.
3. The final rule includes an interim final rule with a comment period to seek feedback on the final policy and provide additional flexibility in episode of care costs for providers in areas that were impacted by "extreme and uncontrollable circumstances," including the hurricanes that occurred earlier this year.
4. In the future, CMS expects to roll out additional opportunities for providers to participate in voluntary initiatives instead of mandatory bundled payment models.
5. The agency decided to cancel proposed bundles for hip fractures and cardiac care, and will instead focus efforts on designing and testing models to improve care coordination across the inpatient and post-acute care spectrum.