Opposition to Medicare Bundles is Growing

On December 20, 2016, the Centers for Medicare & Medicaid Services (CMS) announced the roll out of the Acute Myocardial Infarction (AMI), the Coronary Artery Bypass Graft (CABG), and the Cardiac Rehabilitation (CR) incentive payment models. With these programs scheduled to go live in July 2017, they will join expanded Comprehensive Care for Joint Replacement (CJR) bundled payments program, which now includes the Surgical Hip and Femur Fracture Treatment (SHFFT) model for hip surgery.

With the roll out of the new programs imminent, several opponents have begun to voice their reservations with the bundled payment programs from CMS. One of the most outspoken critics of bundled programs is HHS nominee Rep. Tom Price (R-GA), who fears that the programs increase the risk for elderly recipients of such procedures. The American Hospital Association (AHA) also has stated its concern that the programs are being rolled out too quickly. As this article by Christopher Cheney at Health Leader Media noted:

“The bundled payment model for cardiac care is the second mandatory demonstration project the agency has finalized in just the past 15 months. This is too much, too soon,” [Tom] Nickels [Executive Vice President at AHA] said.

“Regrettably, at the same time, the agency finalized its plans to expand and further complicate its existing mandatory hip and knee bundled payment model less than a year after it began, and before fully evaluating its results.”

Read the entire article here: Medicare Bundle Backlash is Brewing

Even with opposition to the growing number of bundled programs mounting, hospitals must still be prepared for the go-live of programs in many markets nationwide. In order to ensure preparedness, hospitals can look to find efficiencies and other gains to offset the increased risk that comes with bundles. While many hospitals claim that they will be losing money on the new bundles, this doesn’t have to be the rule for all hospitals. Administrators can take steps now to work closely with doctors and staff to streamline operations, use data to improve outcomes and cut back on supply expenditures to increase margins. With these steps in place, hospitals will be on their way to profitability even in the bundled world.