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Cardiac and orthopedic bundled payment models delayed to Jan 1, 2018

In a final rule published in the Federal Register today, May 19, the Department of Health and Human Services (HHS) finalized May 20, 2017 as the effective date of the bundled payment models and changes to the Comprehensive Care for Joint Replacement Model and delayed the implementation date of the final rule to January 1, 2018. This marks the third time the rule’s implementation date has been changed.

The final rule, titled “Advancing Care Coordination Through Episode Payment Models (EPMs); Cardiac Rehabilitation Incentive Payment Model; and Changes to the Comprehensive Care for Joint Replacement Model (CJR),” implements three new Medicare Parts A and B episode payment models, a cardiac rehabilitation incentive payment model, and changes to the existing CJR model.

HHS stated that they may consider comments asking that the models be made voluntary rather than mandatory for future rulemaking, but do not intent to respond to them for this final rule, believing that these models will further the agency’s goals of improving the efficiency and quality of care for Medicare beneficiaries. The agency did heed the majority of commenters’ requests to extend the implementation date, however, agreeing to move the deadline from October 1, 2017 to January 1, 2018, stating in the final rule that “delaying the EPMs’ and CR incentive payment model’s start date dates until January 1, 2018 will ensure that CMS has adequate time to undertake notice and comment rulemaking, if modifications are warranted. This would ensure that, in the case of any policy changes, participants would have a clear understanding of the governing rules before episodes begin and have the opportunity to take additional steps to adjust to any potential changes that may be effectuated.”