CMS proposes bundled payment models for cardiac and hip fracture care

July 28, 2016

The Centers for Medicare & Medicaid Services (CMS) on July 25 proposed a new payment model that would bundle payment to acute care hospitals for heart attack and cardiac bypass surgery services. The proposed rule also would expand the existing Comprehensive Care for Joint (CJR) Replacement model to include other surgical treatments for hip and femur fractures beyond hip replacement.

Under both the new cardiac bundled payment model and the expanded CJR model, the hospital in which the initial services are provided would be held accountable for the quality and costs of care for the entire episode of care from the time of the hospital stay through 90 days after discharge. The hospital would either earn a financial reward or be required to repay Medicare for a portion of the costs based on its performance on cost and quality for the episode. Click here to read more from the American Hospital Association.

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