Com­ments on new car­diac pay model due Oct. 3

Modern Healthcare - - THE WEEK AHEAD - —Vir­gil Dick­son

Com­ments are due Mon­day on a pro­posed rule that makes hospi­tals in 98 mar­kets fi­nan­cially ac­count­able for the cost and qual­ity of all care as­so­ci­ated with bypass surgery and heart at­tacks. The five-year demon­stra­tion would take ef­fect July 1, 2017.

The agency was mo­ti­vated to pro­pose the change be­cause of wild vari­a­tion in cost. In 2014, hos­pi­tal­iza­tions for heart at­tacks for more than 200,000 ben­e­fi­cia­ries cost Medi­care over $6 bil­lion, ac­cord­ing to the CMS. Yet the cost could vary by as much as 50% for the same ser­vices.

In that same rule, the CMS also an­nounced plans to ex­pand its first and manda­tory bun­dled-pay­ment model—which took ef­fect in Jan­uary and cov­ers to­tal hip and knee re­place­ments—to in­clude surg­eries re­pair­ing hip and fe­mur frac­tures.

Of­fi­cials at Catholic Health Sys­tem in Buffalo, N.Y., worry about in­clud­ing hip and fe­mur surg­eries while they are still try­ing to get the rest of the hip and knee re­place­ments model off the ground.

“The ad­di­tion could have a sig­nif­i­cant neg­a­tive im­pact on our hospi­tals who will be at risk for not only the cost and qual­ity of our in­pa­tient care, but the cost of other un­re­lated fa­cil­i­ties and providers af­ter dis­charge of our pa­tients from our hospi­tals,” Michael Os­borne, vice pres­i­dent of fi­nance at the sys­tem, wrote to the CMS.

He rec­om­mended that the new pro­gram be de­layed un­til it can an­a­lyze the re­sults of its ini­tial year un­der the Com­pre­hen­sive Care for Joint Re­place­ment Model.

“We re­main sup­port­ive of health­care re­form and pop­u­la­tion health, how­ever we are con­cerned with the pace and need for this seem­ingly ar­bi­trary change,” Os­borne said.

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