The proposed 5-year payment model would apply to 75 regions across the country and nearly all hospitals in those areas would be required to participate.
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“The American Medical Group Association (AMGA) supports the nomination of Andy Slavitt as Administrator of the Centers for Medicare & Medicaid Services (CMS)”.
One needs to shell out between $16,500 and $33,000 for Medicare hip and knee replacement depending upon the area.
Health officials said they chose hip and knee replacements because they are the most commonly performed Medicare inpatient surgeries and are expected to continue to grow as the population ages.
“For instance, the rate of complications like infections or implant failures after surgery can be more than three times higher at some facilities than others, increasing the chances that the patient may be re-admitted to the hospital”, the agency said.
Under the government’s plan, hospitals would receive a bundled amount covering the surgery and any related care 90 days after discharge.
Tricia Neuman, a senior vice president at the Kaiser Family Foundation and a Medicare expert, said the experiment is consistent with the administration’s ongoing push to improve the quality of care and lower costs, and could greatly benefit patients. “The time has come to work together productively to ensure all Americans have the security of health care coverage, and I look forward to Mr. Slavitt’s timely confirmation as a part of that effort”.
In a statement responding to the nomination, Senate Majority Leader Mitch McConnell, R-Ken., said the head of the CMS should be focused on Medicare and Medicaid rather than Obamacare. It will reward providers and doctors for helping patients get and stay healthy. Data utilization, spending information and sharing of best practices will be provided to hospitals to aid in improving coordination of care between physicians, home health providers and nursing facilities.
A few doctors, hospitals and large employers have already forged ahead with this idea of bundled payments for heart, spine and transplant surgeries.
To resolve issues of fragmentation in the system the agency has proposed a new payment model of “Comprehensive Care for Joint Replacement”.
CMS recognizes that this would be a new way of doing business for many hospitals and we are committed to working with hospitals and providers as they transition to this model.
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A 60-day comment period is in effect for the proposed rule.
