CMS finalizes cardiac, orthopedic care bundled pay models

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The Centers for Medicare & Medicaid Services on Tuesday announced the finalization of four new bundled payment models, but some observers speculate the policies will soon find themselves on the chopping block under the new administration.

CMS' final rule cements three new bundled payment models focused on cardiac care. A model for patients who receive cardiac rehabilitation will be implemented in 45 geographic areas, while models for beneficiaries who suffer heart attacks or undergo heart surgery will be implemented in 98 geographic areas.

A fourth bundled payment model also was finalized, focusing on patients who undergo non-replacement surgery following a hip fracture.

The four new mandatory models are slated to begin demonstrations July 1, 2017, and last through 2021. But some predict they won't reach that point under President-elect Donald Trump's pick for Department of Health and Human Services Secretary, Rep. Tom Price (R-GA). Price led a group of nearly 180 lawmakers who called on CMS in October to stop making new payment models mandatory.

“Expect anything CMS does at the eleventh hour to be on a list for Price to consider killing upon confirmation,” Terry Haines, managing director at economic research firm Evercore ISI, told Modern Healthcare.

The cardiac models were also slammed by Tom Nickels, executive vice president of government relations and public policy for the American Hospital Association, as “too much, too soon.”

Tuesday's final rule also included the announcement of adjustments to the Comprehensive Care for Joint Replacement Model, including “refinements” of the bundle's skilled nursing facility waiver, as well as the creation of a new accountable care organization model aimed at small physician practices.