The Centers for Medicare and Medicaid Services (CMS) will pilot new payment models soon, with a goal of shifting the focus from quantity to quality by encouraging hospitals and health systems to deliver better care at lower cost.
An Episode Payment Model (EPM) for patients treated for acute myocardial infarction (AMI), AMI with Percutaneous Coronary Intervention (PCI), or Coronary Artery Bypass Graft (CABG) surgery will mean a single bundled payment will cover all services from hospital admission through 90-days post hospital discharge.
In addition, an incentive payment model for Cardiac Rehabilitation (CR) will go into effect with the goal of increasing referral and early participation in these vital programs. Cardiac rehabilitation has demonstrated benefits including reduced re-hospitalization, increased treatment compliance and decreased mortality.
Together these benefits result in improved quality of care and reduced cost, thus fall in line with the goals that CMS set forth to achieve with these new payment models. It is important for you to become involved in your hospital or health systems preparation for these changes, which are set to take place July 1, 2017 (barring any changes made by the new administration).
More information about the CR Incentive payment initiative and specific geographic locations selected for the pilot is available here