This article has been updated with comments from naviHealth’s Brian Fuller.
The Department of Health and Human Services has proposed eliminating several mandatory bundled payment programs, including those for heart attacks and joint replacements.
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The news comes from a rule title posted late last week.
Details of the proposed rule are a little vague, given that the only bit of information available is its title: “Cancellation of Advancing Care Coordination through Episode Payment and Cardiac Rehabilitation Incentive Payment Models; Changes to Comprehensive Care for Joint Replacement Payment Model.”
The initiatives are set to take effect on January 1, 2018.
HHS has already delayed the bundles twice this year — once in March and again in May.
This proposed cancellation isn’t too shocking. HHS Secretary Tom Price isn’t a fan of bundled payments. In a letter to CMS last fall, he said that through such mandatory initiatives, the Center for Medicare and Medicaid Innovation was “experimenting with Americans’ health.”
CMS Administrator Seema Verma feels the same. In her confirmation hearing before the Senate Finance Committee earlier this year, she said she doesn’t believe such models should be mandatory.
“We need to make sure we’re not forcing, not mandating individuals to participate in an experiment, a trial that there’s not consent around,” Verma said, according to Health Exec.
“The current administration has been clear that they favor voluntary models in which providers can move to value-based care at the rate they desire, versus a mandatory model,” naviHealth vice president of value-based care Brian Fuller said via email. “The fact that the rule is being reconsidered is not a surprise.”
The rule going through would be another hit for the CMMI, which just lost its director, Patrick Conway, last week. He has taken on a new position as president and CEO of Blue Cross Blue Shield of North Carolina.
Even if the rule is approved, Fuller said, initiatives like the Bundled Payments for Care Improvement will likely move forward.
“We see the shift toward value-based care — whether mandatory or voluntary — as a positive for American healthcare,” Fuller added. “Not only does it reduce unnecessary medical costs, but it focuses on improving patient outcomes and ensuring patients are at the center of every decision.”
Will these mandatory bundled payment models bite the dust? We’ll have to wait and see.
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