Abstract
If you’re a practicing physician in the U.S. like me, April 1 will probably feel no different than any other busy day involved in patient care. But April 1 will be no April fools this year. With its first mandated bundled payment initiative set to start on that date, the Centers for Medicare & Medicaid Services (CMS) has sent with it, the first big signal that hospitals and providers will increasingly be expected to assume financial risk for the healthcare utilization and outcomes of their patients for a period of time after discharge. Huge dollars are at stakes that are meant to incentivize reimbursement for patient outcomes rather than for the quantity of services provided. While our orthopedic colleagues and hospital administrators will be the first to feel these growing pains through CMS’ April 1 launch of the Comprehensive Care for Joint Replacement (CJR) initiative [1], this is a wakeup call to those of us across all other medical specialties. With new value-based programs set to launch under the Alternative Payment Models (APMs) and the Merit-Based Incentive Payment System (MIPS) of the Medicare Access and CHIP Reauthorization Act (MACRA) [2], CMS is driving a transition away from fee-for-service to value-based reimbursement at an incredible clip. Its goal is to have 30% of Medicare payments in alternative payment models by the end of 2016 and 50% by the end of 2018.
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