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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.

To read the whole article, please hit this link.



Behind the latest wave of mergers


Becker’s Hospital Review looks at the big mergers announced on April 28. Some of its observations:

1. “Some of the leading deals include Abbott’s proposed purchase of St. Jude Medical for $25 billion, a move intended to expand the former’s presence in the cardiovascular device sphere. To gain an edge in the prostate cancer treatment market, Sanofi made a bid to buy Medivation for about $9.3 billion. AbbVie signed a $5.8 billion deal to acquire Stemcentrxm to drive into oncology treatments….”

2. “The frenzy of deals is linked to new regulations, new payment models and the perceived need to keep pace with the record consolidation occurring within the industry — healthcare company executives see no option other than to scale up. …”

3. The introduction of mandatory bundled payment through the Comprehensive Care for Joint Replacement Model is one of the new regulations pushing healthcare companies to team up. With the goal of making healthcare less expensive and more efficient, organizations that solidify their positions as leading providers of a product or service will be the most attractive partners for hospitals and insurers in bundled deals, while smaller firms are more likely to be skipped over.”


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