Shifting Landscape for Bundled Payments for Heart Conditions.

Abstract

Hospitals will have a choice in whether they wish to participate in the Centers for Medicare & Medicaid Service’s (CMS) bundled payment programs for heart conditions under a new proposal released in January 2018. The new proposal is the latest twist in the shift away from fee-for-service payments toward value-based payments in American health care. The proposal followed the November 2017 cancellation of a CMS mandatory bundled payment program for acute myocardial infarction (AMI) slated to roll out at hospitals in 98 randomly selected metropolitan areas in early 2018. The shift toward a voluntary program suggests the Trump administration plans to take a different approach to value-based payments. “While CMS continues to believe that bundled payment models offer opportunities to improve quality and care coordination while lowering spending, we believe that focusing on developing different bundled payment models and engaging more providers is the best way to drive health system change while minimizing burden and maintaining access to care,” wrote CMS Administrator Seema Verma in a statement about the cancellation. Many hospitals had already made preparations for the mandatory AMI bundles by creating the necessary data infrastructure and establishing partnerships with outpatient centers to help them track and improve patients’ postacute care. But the cancellation put many plans …