News: CMS issues proposed rule for mandatory episode payment models

The new retrospective mandatory episode payment model for acute myocardial infarction (AMI) included in the August 2 issue of the Federal Register, includes measures for coronary artery bypass graft (CABG) admissions for 98 yet-to-be-named geographic areas beginning in July 2017.

CMS hopes to have 30% of payments tied to alternative payment models (including bundled and episodic payments) by 2016, and 50% of its payments tied to APMs by 2018, according to Cheryl Ericson, MS, RN, CCDS, CDIP, manager of clinical documentation services with DHG Healthcare, who spoke on the subject in a recent edition of ACDIS Radio. Episode and bundled payment models can be either elective or mandatory but the AMI/CABG models would be mandatory, include both Part A and Part B medical and surgical services during inpatient hospitalization through 90 days, post-discharge, says CMS.

The comment period for this rule ended on October 3. The final rule will be released by the end of the year. Click here to read the complete proposal.