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After big payouts, Medicare may throttle back bundled payment program

By: Rich Daly, HFMA senior writer and editor

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  • Proposed changes would switch Medicare’s voluntary bundled payments program from using prospective to retrospective calculations.
  • The changes would have resulted in $34 million in penalties over the first two years, according to an analysis, instead of the $650 million in bonuses that were paid.
  • Some support the changes, while others warn they could drive some of the 1,700 participants from the program.

Medicare has proposed significant changes to its largest bundled payment programs, and the modifications could slash bonuses and drive hospitals out of the voluntary model.

CMS recently proposed changes to its voluntary Bundled Payments for Care Improvement Advanced (BPCI-A) model, the biggest of which would be switching from calculating savings prospectively to retrospectively.

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