November 30, 2017

CMS finalizes changes to bundled-payment models

By: Judy Mathias

Editor’s Note

The Centers for Medicare & Medicaid Services (CMS) on November 30 announced a final rule that cancels the mandatory hip fracture and cardiac bundled-payment models, which were to begin on January 1, 2018, and implements changes to the Comprehensive Care for Joint Replacement (CJR) Model.

In the final rule, CMS is reducing the number of mandatory geographic areas participating in CJR from 67 to 34 areas and is making participation voluntary for low-volume and rural hospitals.

The agency also issued an interim final rule with comment period in conjunction with the final rule to address the need for a policy to provide flexibility in the determination of episode costs for CJR hospitals located in areas impacted by extreme and uncontrollable circumstances, such as major hurricanes. Comments will be accepted through January 31, 2018.

In the future, CMS expects to increase opportunities for providers to participate in voluntary initiatives rather than large mandatory bundled-payment models.



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