CMS Adds Two More Advanced APMs, Finalize Cardiac, Orthopedic Bundled Payment Models

January 2017 ~

CMS has finalized the cardiac and orthopedic care mandatory demonstration bundles as well as added two more Advanced Alternative Payment Models (APMs), in an effort to increase the number of providers who will be eligible to receive a 5% payment incentive under the Quality Payment Program recently established by MACRA.

The updated policies, announced December 20, establish that hospitals in which a Medicare patient is admitted for care for a heart attack, bypass surgery, or a hip or femur procedure will be held accountable for the quality and cost of care provided to Medicare fee-for-service beneficiaries during the inpatient stay and for 90 days after discharge. As well, clinicians s receiving 25% of payments from Medicare or with 20% of patients who are Medicare beneficiaries can qualify under the Quality Payment Program, the announcement finalizes a number of policies, including the cardiac and orthopedic.

Source(s): CMS; Healthcare Dive; Modern Healthcare;