Cardiac Care Bundled Pay Models Preserve New Tech Add-Ons, But Still Make Medtech Nervous
The US Center for Medicare and Medicaid Services finalized three new bundled payment models for cardiac care and one for hip surgeries that will prompt hospitals to adopt them by providing clinicians up to 5% more for Medicare reimbursements. The cardiac and joint care models look similar to last year's "Comprehensive Care for Joint Replacement" plan, in that they still permit inpatient new technology add-on payments and outpatient transitional pass-through payments for device use by excluding those costs from episode payment model calculations.
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Trump's new CMS Chief Seema Verma has only been in place for a week, but an agency decision to delay implementation of two bundled-payment initiatives – one on cardiac care and one on joint replacements – underscores the administration's wariness of mandatory value-based payment models.
The Senate confirmed former health-policy consultant Seema Verma as administrator of the US Centers for Medicare and Medicaid Services earlier this month, and she was sworn in March 14. Medtech Insight took a look at some of Verma's policy positions affecting industry, including potential changes to accountable care organizations, appropriate-use criteria, the Centers for Medicare and Medicaid Innovation, lab payments, and telehealth services.
Seema Verma, President Trump's nominee to lead the Medicare agency, was approved by the Senate Finance Committee March 2 on a narrow 13-12 vote; her confirmation will now be taken up by the full Senate. Questions remain about Verma's viewpoints related to replacement of the Affordable Care Act and on promoting alternative Medicare value-based payment models.