Bundled Payment Initiatives Pushed Back Again

The expansion of a bundled payment program and the pilot of another model have been delayed, The Centers for Medicare & Medicaid Services (CMS) announced via the Federal Register on Monday.

The notice seeks to delay the implementation of several models, including the expansion of the Comprehensive Care for Joint Replacement (CJR) Model, the Cardiac Rehabilitation Incentive Payment Model and the care coordination model. The rule pushes back the implementation date from July 1, 2017, to Oct. 1, 2017, for the cardiac care initiative and the implementation of other programs to May 20, 2017.

The new interim final rule comes after President Trump’s executive order put a 60-day freeze on all new regulations last month.


The rule also noted that the agency is seeking comments on the delays, as well as a potential further delay of all bundled payment initiatives until Jan. 1, 2018.

CMS announced its intention to expand mandatory bundled payment programs late last year by creating models for cardiac conditions and expanding the scope of the existing CJR model.

Industry groups and some of the biggest home health care providers have spoken up against the fast pace with which these models are being implemented, stating the viability and effectiveness of the programs has yet to be proven.


Health and Human Services (HHS) Secretary Tom Price has stated similar concerns with the reimbursement models.

“Overall, the rule makes it less likely that there are going to be significant new bundled payment initiatives for home health providers in the short term,” Colin Luke, attorney and partner at health care law firm Waller Lansden Dortch & Davis, told HHCN. “Dr. Price has made it very clear that he wants more provider involvement in bundled payment design and intends to ‘re-tool’ proposed bundled payment programs to allow providers more time to prepare for and implement complex new payment models. In the longer term, the jury is still out on whether bundled payments will become a significant source of reimbursement for home health payments as these programs move to voluntary participation and become more physician and hospital friendly.”

Written by Amy Baxter

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