We pretty much knew it was coming, but on November 30 the Centers for Medicare and Medicaid Services (CMS) finalized its decision to cancel mandatory hip fracture and cardiac bundled payments scheduled to go into effect January 1, 2018. CMS also reduced the number of mandatory Comprehensive Care for Joint Replacement (CJR) Model participants on a mandatory basis from 67 to 34.
In spite of the final rules, CMS Administrator Seema Verma says the agency is still confident that value-based care can improve quality and lower costs. “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. We anticipate announcing new voluntary payment bundles soon,” Verma said in a press release.
While these changes will likely slow the growth of bundled payments as an alternative to the fee-for-service model, 2017 has seen positive development that bode well for the future of value-based care. Studies released earlier this year demonstrate that value-based programs lower costs and episode volume and reduce hospital readmissions. And in October, results for the first year of the CJR program showed that participating hospitals earned $37.6 million in reconciliation payments – with nearly half of MedBen Analytics clients receiving the payments.
“During the past year, we’ve witnessed first-hand the effectiveness of the bundled payment model,” said Kurt Harden, President and COO of MedBen Analytics. “Costs for our clients have gone down with no adverse affect in customer satisfaction. Even with a scaled-back CJR model, we expect to see further positive developments in 2018.”
Whatever changes may lie ahead for bundled payments, MedBen Analytics will continue to give providers the insights they need to improve performance and benefit from value-based care. If you ever have questions about how our services can help your business, please call Harden at 888-633-2364 or email medbenanalytics@medben.com.