On August 2, 2016, the Centers for Medicare & Medicaid Services (CMS) (@CMSGov) published four new payment models and refinements to a current model through a notice of proposed rulemaking to further advance care coordination for Medicare fee-for-service (FFS) beneficiaries, which will begin on July 1, 2017.
Three new episode payment models (EPMs) would test making participants financially accountable for the quality and cost of episodes of care helping achieve the goal of higher quality at a lower cost for the following episodes:
- An acute myocardial infarction (AMI), including both medical therapy and percutaneous coronary intervention (PCI),
- A coronary artery bypass graft (CABG), and
- A surgical hip/femur fracture treatment, excluding lower extremity joint replacements (SHFFT).
The Cardiac Rehabilitation (CR) incentive payment model for EPMs and Medicare FFS participants would test financial incentives for Inpatient Prospective Payment System (IPPS) hospitals that encourage the management of beneficiaries following an AMI or CABG toward greater utilization of CR services.
Lastly, CMS is proposing refinements to the Comprehensive Care for Joint Replacement (CJR) model.
The Center for Medicare & Medicaid Innovation (CMS Innovation Center) will host a webinar to present various aspects of the Advancing Care Coordination through Episode Payment Models (EPMs); Cardiac Incentive Payment Model; and Changes to the Comprehensive Care for Joint Replacement Model proposals on Wednesday, August 31, 2016, from noon-1:00 pm EDT. Registration for this webinar is now open. The agency can answer questions on details of proposed policies, but cannot speculate on final rule decisions.
CMS will accept comments on the proposed rule until October 3, 2016, and will respond to comments in a final rule. The proposed rule can be found on the Federal Register.
To learn more about these efforts, please review the fact sheet and press release.