Post-Acute Care Takes Center Stage in CMS (Centers for Medicare and Medicaid Services) Plan to Expand Use of Bundled Payments for Heart Attack.

Abstract

Understanding what happens to patients after they leave the hospital after a heart attack is going to be essential for hospitals participating in the Centers for Medicare and Medicaid (CMS) new bundled payment plan, which could go into effect as early as July 2017. A new cardiac bundling plan from the Centers for Medicare and Medicaid Services would give providers incentives to boost the use of cardiac rehabilitation. The proposed plan would require hospitals in 98 randomly selected metropolitan areas across the country to receive bundled payments for acute myocardial infarction. The participating hospitals would receive financial incentives to boost patient enrollment and completion of cardiac rehabilitation. Cardiologists participating in this new payment model could qualify for value-based care incentives laid out in the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). The proposal is part of the agency’s effort to shift 50% of the payments currently made through Medicare into alternative payment models by 2018, according to CMS. Approximately 30% of Medicare payments are already made through such value-based payment programs. Both the American Heart Association and the American College of Cardiology were still reviewing and commenting on the details of the CMS proposal at press time, but in statements they expressed support for the overall CMS shift toward value-based care. “As an organization dedicated to reducing disability and death from cardiovascular diseases, we believe that the movement toward value-based payment models may be a way to incentivize high-quality, evidence-based care for patients,” wrote American Heart Association President Steven Houser, PhD, …