News & Events


Uncertainty for Hospitals as Mandatory Bundle Programs Appear Canceled

By: RICH DALY, HFMA SENIOR WRITER/EDITOR

DATE: August 11, 2017

SOURCE: http://www.hfma.org/Content.aspx?id=55240

DataGen was recently featured in an article from hfma.org.

MANY HOSPITALS PREFER THE VOLUNTARY APPROACH USED BY MEDICARE’S BUNDLED PAYMENTS FOR CARE IMPROVEMENT INITIATIVE, AN EXTENSION OF WHICH IS EXPECTED TO BE PROPOSED SOON.

The Trump administration appears set to cancel at least two mandatory Medicare bundled payment programs, according to a preliminary federal notice.

The website for the Office of Management and Budget, which reviews regulations shortly before they are publicly issued, posted a notice Aug. 10 that it was considering a proposed rule titled “Cancellation of Advancing Care Coordination through Episode Payment and Cardiac Rehabilitation Incentive Payment Models; Changes to Comprehensive Care for Joint Replacement Payment Model.”

Asked to clarify the proposed rule, a Centers for Medicare & Medicaid Services (CMS) spokesman said the agency does not comment on “pending rules or regulations.”

The Episode Payment Model (EPM) and Cardiac Rehabilitation Model (CRM), both of which CMS has delayed twice in recent months, were supposed to launch in January 2018. The changes would affect 860 hospitals already in CJR and 1,120 in the two other mandatory models, according to CMS figures.

Darcie Hurteau, a director for advisory company DataGen, was not surprised that CMS apparently is canceling the EPM and CRM programs, although it is less clear whether the agency is moving to either curtail or make voluntary the CJR model, which started in the summer of 2016 and was Medicare’s first mandatory payment model.

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