HHS Issues New Proposed Rule on Cardiac Bundled Payment Models

On Monday, July 25, the Department of Health and Human Services (HHS) announced a new proposed rule to improve the quality of care and reduce costs for beneficiaries who have a heart attack or undergo bypass surgery. The new models would reward hospitals that work together with physicians and other providers to avoid complications, prevent hospital readmissions, and speed recovery. The new cardiac bundle will bring providers together to deliver holistic and better care for patients.

The proposed rule includes the following provisions:

  • New bundled payment models for cardiac care and an extension of the existing bundled payment model for hip replacements to other hip surgeries;
  • A new model to increase cardiac rehabilitation utilization; and
  • A proposed pathway for physicians with significant participation in bundled payment models to qualify for payment incentives under the proposed Quality Payment Program.

In an HHS press release, Andy Slavitt, Acting Administrator of the Centers for Medicare and Medicaid Services (CMS), notes that, “Today’s rule adds to the options for specialists who want to participate in Advanced Alternative Payment Models to a significant level.  Expanding these options will help MACRA succeed in its goal of transforming the health care delivery system.” Additionally, HHS Secretary Sylvia M. Burwell states that “Today’s proposal is an important step to improving the quality of care Americans receive and driving down costs. By focusing on episodes of care and rewarding successful recoveries, bundled payments encourage hospitals to coordinate care to achieve the best outcomes possible for patients.”

Comments will be accepted for this proposed rule and will be due 60 days after it is published in the Federal Register. The anticipated publication date is August 2, 2016.