Could CMS Changes To Bundled Pay Models Stifle Medtechs' Value-Based Pay Plans?
The US Center for Medicare and Medicaid Services proposed downsizing its CJR joint replacement value-based payment model and outright canceling its cardiac procedure bundled payment model. Will the move discourage companies like Zimmer Biomet, Johnson & Johnson, and Medtronic, which have already invested in programs based on the value-based models?
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Orthopedic surgeons never favored mandatory bundled-payment programs such as the Comprehensive Care for Joint Replacement model. In fact, in comments to CMS, surgeons requested that the US Center for Medicare and Medicaid Innovation make the programs voluntary and scale them back.
The US Centers for Medicare and Medicaid Services' Innovation Center has launched a new voluntary bundled-payment model covering more than 20 different types of clinical episodes involving devices. But they will limit outcome evaluations to 90 days, which may not be long enough to demonstrate the value of some cardiac care and orthopedic devices.
The latest value-based payment models sponsored by the US Centers for Medicare and Medicaid Services and other institutions lack adequate quality measures to effectively assess the value of medical technologies. That's resulting in patients losing access to device products, says a Discern Health white paper sponsored by AdvaMed.