Last week, the Center for Medicare & Medicaid Innovation (CMMI) within the Centers for Medicare & Medicaid Services (CMS) announced plans to test a new way of paying Medicare providers for many of the services they perform, including major joint replacement and some cardiac interventions. This model—the Bundled Payments for Care Improvement Advanced (BPCI Advanced)—is the first of its kind to be introduced by the Trump administration.
Under traditional Medicare, providers are paid for each individual service. Under this new, voluntary payment model, Medicare will make a single bundled payment for nearly all the services provided in a 90-day period to certain Medicare patients who are admitted to a hospital or have certain outpatient medical procedures.
Medicare Rights is pleased that CMS is moving forward with a new opportunity to test bundled payments. We urge the agency to ensure that vital consumer protections are included in the design and implementation of this and future models. In partnership with AARP, we developed a checklist of protections that should be integrated into the design of all Medicare models, to ensure that any changes to Medicare payment structures do not diminish access to care, care quality, or the overall consumer experience with the program.
Read more about the model and its requirements.
Read about Consumer Protections in New Medicare Payment and Delivery Models: A Checklist.