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CMS to Cancel Mandatory Cardiac, Expanded Joint Replacement Bundles

By: Mary Caffrey

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After months of delays, CMS has quietly called for canceling a pair of mandatory bundled payment programs that were rolled out in the final months of the Obama administration: those for cardiac care, and an expansion of an existing comprehensive joint replacement program (CJR).

The proposed rule, sent August 10, 2017, to the Office of Mandatory and Budget, would halt programs set to take effect January 1, 2018. Both were proposed just over a year ago, with an original launch date of July 1, 2017. Experts who help doctors and hospitals make bundled payment programs work say all signs point to CMS issuing a new rule to continue the Bundled Payments for Care Improvement (BPCI) initiative, a voluntary program that had been schedued to end in 2018. This new version of BPCI would have tweaks to let it qualify as an Advanced Alternative Payment Model (APM) under the Medicare Access and CHIP Reauthorization Act (MACRA).

Last summer, hospital groups said the Center for Medicare and Medicaid Innovation (CMMI) was moving too quickly, having just implemented the initial CJR program for hip and knee replacements. But others said that Medicare had to press ahead with value-based models, even if it made some uncomfortable.

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