CMS issued an interim rule Monday that delays the effective applicability date for new bundled payment regulations from July 1, 2017 to October 1, 2017. The interim rule also delays the effective date of the bundled payment final rule from March 21 to May 20.
A final rule issued by CMS under President Barack Obama would have expanded a voluntary joint replacement bundled payment initiative and required participation for some hospitals in a cardiac care bundled payment initiative.
- The interim rule indicated that the effective applicability date could be pushed back even further to January 1, 2018.
An executive order signed by President Donald Trump in February prompted a delay in implementation of new bundled payment rules, but it had appeared that providers participating in the initiatives would still be required to comply by July 1. However, the recently released interim rule casts doubt on the future of bundled payment initiatives.
CMS had ramped up experiments with bundled payments under Obama. The joint replacement initiative was launched in 2015 to encourage coordination of care across the entire spectrum of a patient’s treatment. Research published earlier this year suggested the initiative helped to decrease spending on joint replacements by $5,000 per patient and to reduce prolonged hospital stays by 67%.
Uncertainty surrounding the future of bundled payment initiatives grew shortly after Rep. Tom Price (R-GA) was nominated to lead HHS. As a member of Congress, Price emerged as a staunch opponent to rules that would require participation in bundled payment initiatives. In a March 2016 statement regarding legislation that would have slowed implementation of bundled payments, Price said, “This new, mandatory payment model handed down from CMS comes with tremendous risk and complexity for patients and health care providers.”
CMS will likely issue an update on rules for bundled payment initiatives by May 20. That update should provide greater insight into the the approach favored by the Trump administration when it comes to bundled payments.