The American College of Cardiology (ACC) and American Heart Association (AHA) released statements this week after the federal government revealed proposals on bundled payments for cardiac care.
On July 25, the Centers for Medicare & Medicaid Services (CMS) announced a five-year plan to hold hospitals responsible for treating Medicare beneficiaries during their inpatient stay for MI or bypass surgery through 90 days after hospital discharge.
Under the proposal, which would begin on July 1, 2017, and last for five years, hospitals would receive a fixed payment for each episode of care. They would then receive extra payments or have their reimbursement reduced based on the quality of care they deliver. CMS plans on randomly selecting hospitals in 98 metropolitan areas to participate in the bundled payments initiative.
CMS also announced a payment model to encourage hospitals to refer patients to cardiac rehabilitation. The agency will provide incentives to hospitals in 90 metropolitan areas if they refer patients to cardiac rehabilitation sessions.
ACC president Richard A. Chazal, MD, said in a statement that the ACC supports value-based care and said both CMS proposals “represent efforts in this direction.” However, he said the proposals may need to be altered.
“While we support the concept, it is important that bundled care models be carried out in such a way that clinicians are given the time and tools to truly impact patient care in the best ways possible,” Chazal said. “Changes in payment structures in health care can pose significant challenges to clinicians and must be driven by clinical practices that improve patient outcomes. We are optimistic that CMS will listen to comments, incorporate feedback from clinicians, and provide ample time for implementation of these new payment models. Our ultimate goal is to improve patient care and to improve heart health.”
AHA president Steven Houser, PhD, FAHA, said in a statement that the cardiac rehabilitation incentive payment model “could be a significant step in the right direction” of increasing the utilization of cardiac rehabilitation among eligible patients.
“We look forward to further reviewing the details of the proposed CR Incentive Payment Model, and we are committed to working with HHS in the design and testing of this new approach for cardiac rehabilitation,” Houser said. “The association is also reviewing the other bundled payment models for cardiac care. We applaud HHS for its leadership in exploring these and other innovative approaches that have the potential to improve the health outcomes and lives of patients with cardiovascular disease.”