The Centers for Medicare & Medicaid Services issued a proposal in mid-August to cancel its Episode Payment and Cardiac Rehabilitation bundled payment models, citing a need for “greater flexibility” in designing new models.

The agency also proposed cutting the number of mandatory geographic participation areas for its Comprehensive Care for Joint Replacement model from 67 to 34. Providers in the remaining areas would be allowed to participate in the model on a voluntary basis.

“These changes … give CMS maximum flexibility to test other episode-based models that will bring about innovation and provide better care for Medicare beneficiaries,” CMS Administrator Seema Verma said.

CMS also noted that the proposal marks what it expects to be the start of more voluntary, as opposed to mandatory, payment initiatives. Comments on the proposals are due by Oct. 16.