CMS recently finalized a new bundled payments initiative for hip and knee replacements; however, the American Association of Orthopaedic Surgeons several of the American Academy of Orthopaedic Surgeons' concerns have not been addressed.
Here are five things to know:
1. AAOS previously raised a number of concerns regarding the proposed rule during the comment period that were not addressed in the final rule. These concerns include the absence of risk-adjustment in the program and a lack of designated physician leadership for episodes-of-care.
3. CMS delayed the implementation date, adding another three months to the original date, but that is not enough for physicians to acquire the tools and find the resources necessary to participate successfully in the program. Participating providers will need better analytics and support, reporting mechanisms and validated patient risk assessment measures.
3. CMS has made some progress to providing physicians with data sharing tools required through hospital and payer transparency, but strengthened support and infrastructure for these programs still requires significant investment and development.
4. AAOS recommended that CMS postpone the mandatory program implementation until a minimum of 85 percent of providers have attained meaningful use or another infrastructure readiness metric.
5. The bundled payment program will be implemented for knee and hip replacements at 67 hospitals in randomly selected geographic areas; this is down from the proposed 75 hospitals to participate in the program.
"The AAOS supports efforts by CMS to make appropriately structured alternative payment models available to physicians and other providers," said David D. Teuscher, MD, president of AAOS. "But we are very concerned about serious unintended consequences for Medicare beneficiaries and physicians."