News | August 14, 2017 | Dave Fornell

CMS May Cancel Orthopedic and Cardiac Bundled Payments

CMS considers eliminating or changing bundled payments for orthopedic and knee replacement imaging. Photo by Vital Images

CMS is considering elimination or changing bundled payments for knee replacements. 

Read the updated version of this story with more details from CMS — "CMS to Cancel Mandatory Cardiac Bundled Payments and Joint Replacement Payment Model."

 

Aug. 14, 2017 — The Centers for Medicare and Medicaid Services (CMS) may eliminate the cardiac rehabilitation incentive payments and orthopedic bundled payments that were planned to go into effect Jan. 1, 2018. 

rule posted to the Federal Register Aug. 10 is titled "Advancing Care Coordination Through Episode Payment Models (EPMs) (CMS-5524-P)." It shows CMS may cancel or modify two mandatory bundled payment programs for cardiac rehabilitation incentives, joint replacements and episode payment models.

CMS has delayed these bundles two times so far since President Trump appointed HHS Secretary Tom Price, M.D., and CMS Administrator Seema Verma, MPH. Both have been critics of mandatory bundled payments. 

Specifically, the new rule proposes to modify the Comprehensive Care for Joint Replacement model, the Episode Payment Models (EPMs), the Cardiac Rehabilitation (CR) Incentive Payment Model, and the Comprehensive Care for Joint Replacement (CJR) model. The rule change is listed as “economically significant” and is only in proposed rule stage. 

At the Summer 2017 National Governors Association Meeting in July, Verma said CMS is starting a major deregulation initiative. She said the move is designed to make it easier for healthcare providers and states to spend more time and resources focusing on delivering care, and less time and resources trying to comply with complex regulations that don’t meaningfully improve care, quality or safety. Read comments made by Verma and Price at the July meeting.

It is not clear from the limited information provided about the proposed rule if it would further delay implementation of the bundled payments, eliminate them or make them voluntary. 

Attempts were made to reach the CMS contact listed on the proposed rule document, but the e-mail address did not work.  William Polglase, CMS public affairs specialist/press office, responded and said CMS cannot comment on pending rules or regulations. 

 

Related Bundled Payment Content:

Radiology is Not Business as Usual

Federal Requirements for Clinical Decision Support for Imaging

HHS Sets Clear Goals, Timeline for Shifting Reimbursements From Volume to Value

HHS Finalizes Bundled Payments for Cardiac, Orthopedic Care

Preparing for Cardiology Bundled Payments in 2017

VIDEO: MACRA's Impact on Cardiology — Interview with Kim Williams, M.D.

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