NAHC Prepares Comments on Medicare Proposal to Bundle Joint Replacement Payments
September 4, 2015 10:17 AM
The National Association for Home Care & Hospice (NAHC) has drafted comments that will be submitted in response to CMS’s proposal to establish a 90 day episode “bundling” program in 75 MSAs focused on patients with complete knee and hip replacements. Under that proposal, hospitals in the designated areas will face the opportunity for financial rewards and penalties when the overall Medicare spending on patients receiving these joint replacements from their facilities are greater than or less than the established Target Price. Among the services included within the “bundle” are home health services and hospice care.
The draft comments can be found here.
Under the proposal, all providers will continue to be paid under the current fee for services payment model applicable to their provider sector. In other words, Medicare will still pay home health agencies under the current episodic prospective payment model and hospices under its per diem payment model.
Patients will retain the full freedom to choose any qualified provider of post-acute care. However, it will be in the interests of the hospitals to manage both the inpatient and post-acute care to the best clinical and spending outcomes. The hospitals will be permitted to share both rewards and losses with other provider participants similar to the existing ACO demonstration programs.
The comments that NAHC drafted are not final. Nevertheless, as is our custom, we are providing the draft to our membership in order to assist those who wish to individually submit comments on the rule.
The deadline for submitting comments to CMS is September 8, 2015. Electronic submission is the easiest method, which is available here.