On Thursday, May 18, 2017, the Centers for Medicare & Medicaid Services (CMS) officially finalized its plan to delay the start of a bundled payment initiative for episode payment models (EPMs) from October 1, 2017 to January 1, 2018 following a previous three-month delay. Under the EPM initiative, acute care hospitals in certain selected geographic areas will be required to participate in retrospective EPMs targeting care for Medicare fee-for-service beneficiaries receiving services during acute myocardial infarction (AMI), coronary artery bypass graft (CABG), and surgical hip/femur  fracture treatment (SHFFT) episodes. All related care within 90 days of hospital discharge will be included in the episode of care. CMS said it delayed the implementation after hospitals asked for more time to “evaluate the final model provisions, to develop specific EPM care plans and to update health information technology.”

The move also delays changes that would make the comprehensive care for joint replacement (CJR) program an Advanced Alternative Payment Model until January 1, 2018.

CMS first proposed these most recent delays on March 21, 2017. On that same day, CMS forwarded to the White House Office of Management and Budget a proposed rule making updates to the Quality Payment Program (aka MIPS and APMs) for review. It is likely that this proposed rule, when ultimately released, will outline the new Administration’s intended vision for Medicare value-based care payments to physicians. “If the Administration intends to remove the mandatory nature of the CJR and other EPMs, the upcoming proposed rule would be the most likely vehicle for this action,” according to a summary prepared for AAHKS by Epstein Becker & Green.

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