Representatives Diane Black (R-TN) and Richard Neal (D-MA) today introduced the Comprehensive Care Payment Innovation Act (HR 2502), that would create a permanent, voluntary Medicare bundled payment program. In a letter to Reps. Black and Neal, Premier offered strong support for the bipartisan legislation, which would create, as part of Medicare, a permanent program that provides bundled payments for integrated care furnished by a group of healthcare providers and suppliers during an episode of care.
“With so many health provider organizations already demonstrating positive results through private market bundled payment programs, this legislation is critical to expanding the alternative payment models that are already working for patients nationwide,” said Blair Childs, Premier Senior Vice President of Public Affairs. “Expanding the alternative payment opportunities through the national voluntary bundled payment program is particularly meaningful to patients, payers and providers, given the recent enactment of H.R. 2, the Medicare Access and CHIP Reauthorization Act, and recent statements by CMS regarding its expectation to reach 90 percent value-based payments by 2018.”
The Comprehensive Care Payment Innovation (CCPI) program will define an episode of care as three days prior to a beneficiary’s hospital admission for an applicable condition through 90 days post-discharge. The program will initially cover six conditions including: Hip/Knee joint replacement; Lumbar spine fusion; Coronary artery bypass graft; Heart valve replacement; Percutaneous coronary intervention with stent; and Colon resection.
Under the program, providers will be responsible for meeting quality requirements and the cost of all Medicare Part A and B services throughout the episode. Finally, the legislation creates two payment models. The first is a retrospective reconciliation model, where providers will have their fee-for-service payments reconciled retrospectively, and will have the opportunity to share in first dollar savings with the Centers for Medicare & Medicaid Services (CMS). The second option is a prospective model, where providers would receive a lump payment at the beginning of the episode. Contracts for the program will last 5 years.