CMS Scraps Key Mandatory Bundled Payment Programs

Last Thursday CMS cancelled two mandatory bundled payment models – relating to hip fracture and cardiac care – that were scheduled to begin on January 1. CMS also changed the parameters of the Comprehensive Care for Joint Replacement (CJR) Model, reducing the mandatory geographic areas participating in CJR from 67 areas to 34.

The bundled payment models were created during the Obama Administration as a way of shifting from fee-for-service reimbursement to reimbursements based on expected costs for different types of care. The Trump Administration’s first Health & Human Services Secretary, Tom Price, while in Congress had been an opponent of such mandatory models as had many provider groups who argued that the evidence for their cost-cutting was scant.

In its notice last Thursday, CMS said, “CMS expects to increase opportunities for providers to participate in voluntary initiatives rather than large mandatory bundled payment models.”