The Centers for Medicare & Medicaid Services is delaying the start of three cardiac payment bundles finalized at the end of 2016.
The bundles include the Acute Myocardial Infarction (AMI) model, the Coronary Artery Bypass Graft (CABG) model, and the Cardiac Rehabilitation Incentive Payment model.
The payment bundles were schedule to go into effect on July 1, 2017, but an interim final rule published March 21 in the Federal Register delayed the start of the bundles for 3 months. The agency also is seeking comment on potentially delaying implementation of the bundles to Jan. 1, 2018.
“This additional 3-month delay is necessary to allow time for additional review, to ensure that the agency has adequate time to undertake notice and comment rulemaking to modify the policy if modifications are warranted, and to ensure that in such a case participants have a clear understanding of the governing rules and are not required to take needless compliance steps due to the rule taking effect for a short duration before any potential modifications are effectuated,” the interim final rule states.
The bundled payment models would place accountability for patient outcomes 90 days after discharge on the hospital where treatment occurred. Hospitals in 98 randomly selected metropolitan statistical areas would be placed in this model and monitored for 5 years to test whether the models lead to improved outcomes and lower costs.
For the cardiac rehabilitation model, CMS would be testing whether an incentive payment would increase the use of cardiac rehabilitation services during a care period that runs parallel with the AMI and CABG payment bundles.
Physician participation in the bundles would have been voluntary, but those participating would have been eligible for bonus payments under the Quality Payment Program as the bundles were considered advanced Alternative Payment Models.
The final rule also delays changes to the comprehensive joint replacement bundle.
CMS had announced the final rule implementing the payment bundles on Dec. 20, 2016, but it was not published in the Federal Register until Jan. 3, 2017. The March 21 interim final rule delaying the start of the bundles cites the Trump administration’s memorandum to federal agencies freezing in-process regulations to allow for review.
