Notice of Proposed Rulemaking for Bundled Payment Models for High-Quality, Coordinated Cardiac Care
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On July 25, 2016, the U.S. Department of Health & Human Services (DHHS) proposed a new bundling model as part of its mission to shift Medicare payments from quantity to quality. In this model CMS proposes to add cardiac care as an extension of the existing bundled payment program for hip replacements. The model would also include a program to increase cardiac rehabilitation utilization. Hospitals and physicians with significant participation in the bundled payment program would qualify for payment incentives based on quality of care. The goal is to create a strong incentive for hospitals to deliver better care at a lower cost and reward hospitals, physicians and other providers who avoid complications, prevent hospital readmissions, and speed recovery.

The link to this proposed rulemaking is here:

https://innovation.cms.gov/Files/x/advancing-care-coordination-nprm.pdf

A CMS summary of the proposed rulemaking is here:

https://www.cms.gov/Newsroom/MediaReleaseDatabase/Fact-sheets/2016-Fact-sheets-items/2016-07-25.html

 

How will this work?  

Under the proposed bundled payment plan, the hospital in which a patient is admitted for care for a heart attack or bypass surgery will be accountable for the cost and quality of care provided to Medicare fee-for-service beneficiaries during the inpatient stay and for 90 days after discharge. Participating hospitals would be paid a fixed target price for each episode of care, with hospitals that deliver higher quality care receiving a higher target price.

SCCT’s Advocacy Committee (consisting of several dedicated volunteers and expert staff) is preparing comments to DHHS on this proposed bundling model by the due date of September 26, 2016.  SCCT members are encouraged to submit any comments to Dr. Ahmad Slim (SCCT Advocacy Committee Chair) ahmadmslim@gmail.com.   

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