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CMS Cancels Two Mandatory Bundled Payment Models

December 01, 2017

The Centers for Medicare & Medicaid Services (CMS) finalized its decision to cancel two mandatory bundled payment models and reduce the number of providers required to participate in a third model.

In rulemaking released yesterday, CMS canceled the Cardiac and Surgical Hip and Femur Fracture Treatment bundled payment programs slated to begin January 1, 2018.

CMS also reduced mandatory participation in the Comprehensive Care for Joint Replacement model by:

  • Cutting nearly in half (from 67 to 34) the number of “mandatory” geographic areas where hospitals are required to participate in the model
  • Making participation voluntary for low volume and rural hospitals in all 67 areas, including the 34 “mandatory” areas 

When issuing the final rule, CMS Administrator Seema Verma indicated that CMS will soon announce new voluntary payment bundles and reaffirmed CMS’ belief that bundled payment models offer opportunity to improve quality and care coordination and reduce health care spending.

HAP continues work with hospitals and health systems as they transition from fee-for-service based payment models to those that reimburse based on value and outcomes. 

For additional information about HAP efforts to shape payment reforms, contact Kate Slatt, HAP’s senior director, innovative payment and care delivery.

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