Comments are due Monday on a proposed rule that makes hospitals in 98 markets financially accountable for the cost and quality of all care associated with bypass surgery and heart attacks. The five-year demonstration would take effect July 1, 2017.
The agency was motivated to propose the change because of wild variation in cost. In 2014, hospitalizations for heart attacks for more than 200,000 beneficiaries cost Medicare over $6 billion, according to the CMS. Yet the cost could vary by as much as 50% for the same services.
In that same rule, the CMS also announced plans to expand its first and mandatory bundled-payment model—which took effect in January and covers total hip and knee replacements—to include surgeries repairing hip and femur fractures.
Officials at Catholic Health System in Buffalo, N.Y., worry about including hip and femur surgeries while they are still trying to get the rest of the hip and knee replacements model off the ground.
“The addition could have a significant negative impact on our hospitals who will be at risk for not only the cost and quality of our inpatient care, but the cost of other unrelated facilities and providers after discharge of our patients from our hospitals,” Michael Osborne, vice president of finance at the system, wrote to the CMS.
He recommended that the new program be delayed until it can analyze the results of its initial year under the Comprehensive Care for Joint Replacement Model.
“We remain supportive of healthcare reform and population health, however we are concerned with the pace and need for this seemingly arbitrary change,” Osborne said.
