Physicians and hospitals will have more ways to participate in Medicare's new alternative payment models (APMs) under programs announced Dec. 20 by the Centers for Medicare & Medicaid Services. The four models announced are for cardiac and orthopedic care for Medicare beneficiaries -- specifically heart attack care, bypass surgery, and hip and femur procedures.
Hospitals in 98 metropolitan areas will be participating in the cardiac care models, while hospitals in 67 metropolitan areas -- the same ones participating in Medicare's joint replacement bundled payment model -- will be part of the orthopedic model. Both models will be in operation for 5 years beginning on July 1, 2017. The new programs will be mandatory for the hospitals in the affected geographic area, but voluntary for physicians.
The hospitals that beneficiaries are admitted to for these procedures will be held accountable for the quality and cost of care during both the inpatient stay and for 90 days afterward. Learn more here.
Both models have drawn criticism that the Center for Medicare & Medicaid Innovation is overreaching its mandate by compelling participation, including from President-elect Donald Trump's nominee for HHS secretary, Rep. Tom Price (R-Ga.). Price could pull the plug on the five-year demonstration, which is now scheduled to take effect July 1, 2017.
NOTE: If you are an MHA member and your hospital is included in these mandatory programs, you will be receiving impact reports from us soon. We will also be scheduling educational webinars. For more information, contact Steve Lesley at (800) 289-8884, (601) 368-3312 or firstname.lastname@example.org.