CMS delays bundled payment expansion, again
- The CMS recently issued a final rule delaying the effective applicability date for new bundled payment regulations from July 1, 2017, to Jan. 1, 2018.
- This is not the first time the agency has delayed the effective date. In March, the CMS issued an interim rule that delayed effective dates.
- The agency, under President Barack Obama, had finalized the orthopedic and cardiac mandatory bundle demonstrations before the change in administration.
The delay is not shocking news. The agency has already pushed back the effective dates once.
While evidence on alternative payment models has been all over the place, the joint bundled payment model was found in one study to reduce spending by over $5,000 per episode. In contrast, the CMS itself found mixed results: Orthopedic surgery bundles yielding savings of over $860 per episode while spinal surgery episodes actually increased costs.
What's up in the air is whether the CMS will bite the bullet and actually finalize the programs. On one hand, HHS Secretary Tom Price has a reputation for disliking bundled payment programs. However, the agency does not seem to be writing off the programs completely.
In the final rule, the CMS highlighted that the agency disagrees with commenters who suggest scraping the models or delaying them forever. "As we stated in the January 3, 2017, EPM final rule, we believe these models will further our goals of improving the efficiency and quality of care for Medicare beneficiaries receiving care for these common clinical conditions and procedures," the agency noted in the final rule, signaling it may eventually come around to making the program final.
- Healthcare Dive New CMS APMs finalize cardiac, orthopedic bundled payment models
- Healthcare Dive CMS delays expansion of bundled payment initiatives
- CMS Final Rule
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