The Centers for Medicare and Medicaid Services in a final rule released Thursday, November 30, 2017, closed the loop on its proposed cancellation of the cardiac bundled payment models. Previously, CMS requested comments regarding new payment models from the Center for Medicare and Medicaid Innovation. CFA posted an article on the CMS input request here on September 20, 2017.
In addition, CMS reduced the number of geographical areas participating in the bundled joint replacement model program from 67 to 34. These CMS rule changes have been anticipated under the Trump Administration’s stated philosophy of supporting market-based solutions and encouraging more healthcare competition. As such, the Trump Administration has opposed expansion of existing bundles and/or creation of new bundles, and any mandatory participation in bundled payments.
CMS Administrator Seema Verma said the agency anticipated announcing new voluntary payment bundles soon. "While CMS continues to believe that bundled payment models offer opportunities to improve quality and care coordination while lowering spending, we believe that focusing on developing different bundled payment models and engaging more providers is the best way to drive health system change while minimizing burden and maintaining access to care," Verma said. CMS has also stated that not pursuing these models gives CMS greater flexibility to design and test innovations that will improve quality and care coordination across the inpatient and post-acute care spectrum.
CMS stated it expects to develop new opportunities for providers to take part in voluntary initiatives rather than large mandatory bundled payment models as have been focused on in the past.