In an attempt to encourage coordinated care, improve the quality of care and decrease costs for heart attack patients, the Centers for Medicare and Medicaid Services (CMS) released a proposed rule [PDF] that introduces bundled payment models for cardiac services. HHS also proposed a new cardiac rehabilitation model and a pathway that helps physicians who are heavily involved in bundled payment models to qualify for incentives as part of the Quality Payment Program, which was proposed as part of the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA).

"The ACC supports the movement toward value based care. Improving quality care and value are central to the ACC's strategic plan," said ACC President Richard A. Chazal, MD, FACC. "The CMS proposed regulation on bundled care models for heart attack and bypass surgery, along with a payment incentive model intended to increase utilization of cardiac rehabilitation, represent efforts in this direction. In addition, CMS is moving in the right direction by proposing tracks under these new models that may qualify as Advanced Alternative Payment Models under MACRA — providing new ways for specialists to be rewarded for delivering quality care."

The announcement is another step toward accomplishing HHS' goal of having 50 percent of Medicare payments tied to alternative models (APMs) by the end of 2018. Currently, more than 30 percent of Medicare Part A and B payments are tied to APMs.

"While we support the concept, it is important that bundled care models be carried out in such a way that clinicians are given the time and tools to truly impact patient care in the best ways possible," Chazal continued. "Changes in payment structures in health care can pose significant challenges to clinicians and must be driven by clinical practices that improve patient outcomes. We are optimistic that CMS will listen to comments, incorporate feedback from clinicians, and provide ample time for implementation of these new payment models."

The ACC plans to review the proposals in detail before submitting recommendations to CMS.

Keywords: Centers for Medicare and Medicaid Services, U.S., Delivery of Health Care, Health Expenditures, Goals, Humans, Medicaid, Medicare, Medicare Part A, Motivation, Myocardial Infarction, Patient Care, Patient Care Bundles, Specialization, Percutaneous Coronary Intervention

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