The Centers for Medicare and Medicaid Services on Monday proposed a new bundled payment model for cardiac care, which would include medical and surgical services.
The policies, for patients who have a heart attack or undergo bypass surgery, would be phased in over five years beginning on July 1 of next year for hospitals in 98 randomly-selected metropolitan areas.
“Today’s proposal is an important step to improving the quality of care Americans receive and driving down costs,” Secretary of Health and Human Services Sylvia Burwell said in a statement. “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.”
Bundled payments aim to improve care quality and coordination by reimbursing providers for an entire episode of care, rather than reimbursing for each separate step. A bundled payment model for hip and knee replacements was launched earlier this year, and the rule proposed Monday would extend that model to include surgical treatments for hip and femur fractures beyond hip replacements.
In addition to the new bundled payment model, the agency also proposed a rule to test incentive payments aimed at increasing the use of cardiac rehabilitation to help patients recovering from some sort of cardiac event.
The Obama administration is aiming for 50 percent of traditional Medicare reimbursements to be made through alternative payment models, which include bundled payments, by 2018.
“Patients want the peace of mind of knowing they will receive high-quality, coordinated care from the minute they’re admitted to the hospital through their recovery,” Patrick Conway, CMS’s chief medical officer, said in a statement. “The variation in cost and quality for the same surgery at different hospitals shows there are major opportunities for hospitals included in today’s models to reduce costs, improve care, and receive additional payments by improving patient outcomes.”