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CMS delays expansion of bundled payment programs

By Elizabeth Whitman | March 20, 2017

(Story updated at 5:40 p.m. ET. )

The CMS has delayed the expansion of a major bundled payment pilot, Comprehensive Care for Joint Replacement, and the implementation of its bundled payment initiatives for cardiac care from July 1 to Oct. 1, 2017, according to an interim final rule posted to the Federal Register. It also delayed, for a second time, the effective date of a final rule laying out the implementation of CJR and other bundled payment programs, from March 21 to May 20, 2017.

The agency also delayed its Cardiac Rehabilitation Incentive Payment Model and is also weighing whether to push back implementation of all bundled payment initiatives even further, until 2018. These programs are mandatory, and different from the voluntary Bundled Payments for Care Improvement initiative, which is not affected by the interim rule.

The Trump administration's move to delay mandatory initiatives raises questions about the future of government initiatives to usher healthcare out of fee-for-service operations and into a new age of value-based payment. Such efforts were a hallmark of healthcare reform under the Obama administration, which set the goal of having half of traditional Medicare dollars go through alternative payment models by 2018.

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