Last week, CMS announced in proposed rulemaking its proposal to cancel the Episode Payment Models (EPMs) and Cardiac Rehabilitation (CR) incentive payment model.
It also announced plans to revise certain aspects of the Comprehensive Care for Joint Replacement (CCJR) model, such as granting certain hospitals selected for participation in the CCJR model a one-time option to choose whether to continue their participation in the CCJR model, and a change to increase the pool of eligible clinicians that qualify as affiliated practitioners under the Advanced Alternative Payment Model track.
CMS noted in the proposed rulemaking that it “continues to believe that cardiac and orthopedic episode models offer opportunities to redesign care processes and improve quality and care coordination across the inpatient and post-acute care spectrum while lowering spending.”
CMS qualified that statement, however, by noting “it is appropriate to propose to rescind the EPMs and CR incentive payment model, and reduce the geographic scope of the CJR model” for several reasons, but most notably due to its belief that the mandatory models could impede its efforts to engage providers in future voluntary payments.
On the other hand, a recent survey of large U.S. employers found that with an average five-percent increase in healthcare costs, employers “plan to focus more on how health care is delivered and paid for while still pursuing traditional methods of controlling costs such as cost sharing and plan design changes.”