Medicare bundled payment programs

Hospitals Flee Downside Risk in Medicare Bundled Programs

More than half of the hospitals that voluntary participate in Medicare bundled payment model programs leave those programs when faced with the possibility of financial penalties based on their performance. So concludes a new report by the U.S. Government Accountability Office. Some of these models feature both “upside” and “downside” risk. Upside risk offers financial incentives to participants that keep their costs below targeted amounts; they share those savings with Medicare. Downside risk occurs when hospitals are penalized when their costs exceed agreed-upon targets. Some of the model programs begin with only upside risk and later move into both upside [...]

Medicare Delays New and Expanded Bundled Payment Programs

Medicare has delayed the launch of its mandatory Medicare Cardiac Rehabilitation Incentive Payment program until January 1. It also has delayed the expansion of its Comprehensive Care for Joint Replacement program through a new Surgical Hip and Femur Fracture Treatment program. Originally scheduled to begin on May 20 and then pushed back to July 1, now it, too, will not begin until January 1. Medicare’s Acute Myocardial Infarction program and Coronary Artery Bypass Graft program will still begin on July 1. For further information, see this Federal Register notice announcing the delays.