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CMS cancels two mandatory bundled-payment models, changes CJR model

Dec 04, 2017

Last Thursday CMS announced that it had finalized the cancellation of the hip fracture and cardiac bundled payment and incentive payment models, officially known as the Episode Payment Models and Cardiac Rehabilitation Incentive Payment Model, which were to be implemented on Jan. 1, 2018.

The final rule also reduces the number of mandatory geographic areas participating in the Comprehensive Care for Joint Replacement (CJR) Model from 67 to 34, and makes participation voluntary for all low-volume and rural hospitals in all 67 geographic areas.

Had the CJR model continued to be mandatory in all 67 geographic regions, it was expected to save Medicare an estimated $295 million over the next three years, according to Modern Healthcare, but with the reduced number of mandatory geographic areas it will save about half that amount, or an estimated $189 million. The canceled cardiac payment models would have saved Medicare an estimated $170 million over five years.

“Moving forward, CMS expects to increase opportunities for providers to participate in voluntary initiatives rather than large mandatory bundled-payment models. The changes in the final rule will help position the agency to engage in future voluntary efforts,” CMS said in a press statement.


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