Bundled Payments

News & Analysis as of

Final ACA Medicaid Drug Pricing Rule Published: Changes to 5i, Bundling, RCP and Other Provisions Leave a Lot for Manufacturers to...

On Thursday, January 21, the Centers for Medicare & Medicaid Services (CMS or “the Agency”) published its long-awaited final rule with comment period implementing the Medicaid pricing and reimbursement provisions of the...more

Day Three Notes – JP Morgan Healthcare Conference, San Francisco

On January 13, 2016, conference sessions surfaced interesting questions and approaches regarding the post-acute sector, bundled payment, emergency medicine and anesthesia. Post-Acute Focus: With more and more focus on...more

[Event] Preparing for the Comprehensive Care Joint Replacement Program - Jan. 5th, 6th, & 7th - Seattle, Portland, Los Angeles

Please join Davis Wright Tremaine partners Bob Homchick and Adam Romney, and associate Kyle Gotchy for a briefing regarding the final rule for the Comprehensive Care Joint Replacement (CJR) Program. They will discuss the...more

Medicare Launches Its First Mandatory Bundled Payment Model for Joint Replacement Care – What You Need to Know to Get Ready

On November 24, 2015, the Centers for Medicare & Medicaid Services (CMS) published a significant final rule that will require hospitals in selected geographic areas to participate in a new Medicare Comprehensive Care for...more

CMS Finalizes Bundled Payment Program for Hip and Knee Replacements

On November 16, 2015, CMS finalized the Comprehensive Care for Joint Replacement (CJR) model. Starting April 1, 2016, certain hospitals will receive retrospective bundled payments for lower extremity joint replacement (LEJR)...more

CMS Finalizes Mandatory Bundled Payment Model for Lower Extremity Joint Replacements

On November 16, 2015, the Centers for Medicare & Medicaid Services (CMS) released final regulations implementing the Comprehensive Care for Joint Replacement Model, its five-year mandatory bundled payment program for hip and...more

CMS Finalizes “Comprehensive Care for Joint Replacement” Model

On November 16, 2015, CMS released its final rule to establish a Medicare Comprehensive Care for Joint Replacement (CJR) model that will test whether bundled payments to acute care hospitals for lower extremity joint...more

The Rosenbaum Law Firm Review - October 2015

Bundled vs. Unbundled 401(k) Plan Providers: The Choice Is Not Clear. Not an easy choice. In our lives, there are times when we have two important choices. It's Coke vs. Pepsi, Mac vs. PC, Xbox vs. PlayStation...more

Manatt on Health Reform: Weekly Highlights - September 2015 #4

The Massachusetts Marketplace takes steps to ease consumer confusion by reducing choice among QHPs; North Carolina appears poised to pass Medicaid reform legislation; and bipartisan support is gaining for defining businesses...more

Clinically Integrated Networks: Privacy and Security Concerns with Sharing Data

The Centers for Medicare & Medicaid Services (CMS) is changing reimbursement methodologies for healthcare providers from a fee-for-service model to a value-based model. Healthcare providers are responding to the changing...more

2014 Medicare ACO Results Released: CMS Asserts Success but Few ACOs Receive Payments

The Centers for Medicare and Medicaid Services (CMS) released, on August 25, 2015, the quality and financial performance results for Medicare Accountable Care Organizations for 2014. CMS touted that Medicare ACOs continued to...more

Key Digital Health Investment Trends to Watch

Our fourth annual Digital Health Summit brought together a select group of investors active in the digital health, life sciences, medical device, and healthcare industries for a one-day meeting to discuss the future of...more

CMS Publishes Corrections to Comprehensive Care for Joint Replacement Model Proposed Rule

On August 25, 2015, the Centers for Medicare & Medicaid Services (CMS) published technical and typographical corrections to its July 14, 2015 proposed rule to establish a Comprehensive Care for Joint Replacement Model. As...more

CMS Issues FY 2016 Final Inpatient and Long-Term Care Hospital Rule

On July 21, 2015, CMS issued a final rule updating the fiscal year (FY) 2016 Medicare payment polices and rates under the Inpatient Prospective Payment System (IPPS) and the Long-Term Care Hospital (LTCH) Prospective Payment...more

Shifting Hospice Reimbursement – Moving in the Direction of Aligning Payment with Resource Concentration

The United States Department of Health and Human Services (HHS) Centers for Medicare & Medicaid Services (CMS) published its update to the home health prospective payment system (HHPPS) for fiscal year (FY) 2016 in the August...more

Key Ingredients of CMS' Proposed Comprehensive Care for Joint Replacement Model

On July 14, 2015, CMS released a proposed rule regarding a new, alternative payment model: the Comprehensive Care for Joint Replacement (CCJR) program. Modeled in large part on the Bundled Payments for Care Improvement (BPCI)...more

CMS Proposes to Revise Payment System for Joint Replacements

On July 9, 2015, CMS released a proposed rule to revise how it pays for joint replacement procedures like hip and knee replacements, also known as lower extremity joint replacements (LEJR). This payment structure, called the...more

CMS Proposes “Comprehensive Care for Joint Replacement” Model

On July 14, 2015, CMS published a proposed rule to establish a Medicare Comprehensive Care for Joint Replacement (CCJR) model. Under the proposed rule, CMS would provide a bundled payment to hospitals in selected geographic...more

Will Personalized Medicine Survive Alternative Payment Models?

There is no doubt that health care costs in the United States are rising. According to a recent study published by the U.S. Department of Health and Human Services, personal health care expenditures in the United States...more

Medicare Bundled Payments Initiative and Oncology Care

According to Modern Healthcare’s “Interest Surges in Medicare Bundled Payment Initiative” article on July 31, 2014, enthusiasm for bundled pricing has been associated with the Medicare Bundled Payments for Care Improvement...more

FTC and DOJ Shine the Spotlight on Conditional Pricing Practices

Signaling increased interest in conditional pricing, the Federal Trade Commission (FTC) and the Antitrust Division of the Department of Justice (DOJ) recently held a one-day workshop to examine the economic, legal, and policy...more

Tax Developments Affecting Health Care Organizations (Presentation)

In this Issue: •Income recognition issues associated with bundled payment arrangements •Income recognition related to electronic health records •Developments involving the nonaccrual experience method of...more

CMS Announces Additional Open Application Period for Bundled Payment Initiative Models 2, 3 & 4

On February 18, 2014, the U.S. Centers for Medicare & Medicaid Services published an announcement in the Federal Register regarding an open period for additional providers to be considered for participation in Models 2, 3 and...more

Also in the News

Additional Open Period Announced for Bundled Payments for Care Improvement Models 2, 3, and 4 – The Center for Medicare and Medicaid Innovation (Innovation Center) is currently testing four episode payment models through the...more

The Year to Come for General Counsel: Payment Reform, Managed Care and Affiliations - Part 1: Payment Reform Four Years After the...

Part one of a three-part series - As the public begins to navigate the health insurance exchanges and healthcare.gov cleans up its glitches, executive leadership of most health systems, hospitals and physician...more

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