Several hospitals and hospital groups say they don't have the money to implement Obama-era bundled-payment initiatives for cardiac and orthopedic care and hope the Trump administration makes them voluntary programs.
The CMS last month delayed the effective dates of four new payment models from July 1 until Oct. 1, 2017, and sought comments on whether they should be delayed even further until Jan. 1, 2018.
Since then, hospitals around the country have submitted comments asking the CMS to turn bundled payments into voluntary initiatives because they can't afford the care-management services and health information technology the models require. The bundled-payment initiative would cripple safety net hospitals that rely mostly on the Medicare, Medicaid and disproportionate-share hospital payments, according to the Greater New York Hospital Association.
The California Hospital Association, among other state groups, has the same concern. The Missouri Hospital Association asked the CMS to cancel any mandatory pay models outright.
"It treats the nation's hospitals as lab rats in the experimentation, with hospitals randomly assigned to implement components of a growing number of complex CMS initiatives," the MHA said in a comment letter.
But Pennsylvania-based Geisinger Health System said allowing hospitals to opt into the programs could lead to some gaming the system by selectively referring or transferring complex patients to providers not participating in the model.