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Providers plead for new-payment-model slowdown


Stressed healthcare providers are pleading with the CMS to slow its flood of new payment models  that the agency is pushing in order to move  healthcare  from fee-for-service to value-based care.

Modern Healthcare reports that “Since the start of the year, the agency has introduced or expanded nine pay models and announced selected markets for another three. In comments on a July proposed rule that would make 98 markets financially accountable for the cost and quality of all care associated with bypass surgery and heart attacks, industry stakeholders ask the agency to step on the brakes.”

The Federation of American Hospitals said its members “have become increasingly concerned about the pace of change proposed by the CMS and the unreasonable expectations and burden that such rapid and multiple changes in the delivery system and related payment structure place on hospitals and their work forces….Simply put, this is too fast and too soon.”

The publication reported that “The trade group said it believes that the CMS first needs to evaluate and learn from hospitals’ Comprehensive Care for Joint Replacement Model, or CJR experience, which is less than 6 months old, and from the results of the Bundled Payments for Care Improvement initiative.”

The American Hospital Association said:  “In failing to take the time to learn from CJR, the agency has missed a critical opportunity to move bundled-payment models forward in a meaningful way. This proposed rule {in July} raises serious concerns about the agency’s pace of change, as well as its ability to accurately track and process the outcomes of its myriad, increasingly complex alternative payment models.”

Hospitals have been  pushing back against the CMS’s proposal to expand the CJR program to include surgical hip and femur fracture treatment episodes, or to make certain CJR hospitals implement the cardiac bundled-payment model. Providers complain that  neither the CMS nor participating hospitals  have had the time or the data to to properly analyze lessons learned from the model as it is.

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