Becker's Hospital Review

12 CFO / FINANCE HHS to launch new mandatory bundled payment models: 4 things to know By Ayla Ellison H HS canceled and scaled back major mandato- ry bundled payment models in 2017 under the leadership of then-Secretary Tom Price, MD. On Nov. 8, HHS Secretary Alex Azar said the agency is reversing course and plans to roll out mandatory bundled payment demonstrations. Here are four things to know: 1. HHS is re-examining the role of bundled payments in the industry's transition to value-based care, Mr. Azar said in a speech at the Patient-Centered Primary Care Collaborative Conference on Nov. 8. 2. In his speech, Mr. Azar discussed some of the cur- rent voluntary models, including Bundled Payments for Care Improvement Advanced. However, he said mandatory models are coming. "Real experimentation with episodic bundles requires a willingness to try mandatory models," he said. "We know they are the most effective way to know wheth- er these bundles can successfully save money and im- prove quality." 3. In 2017, HHS canceled mandatory bundled pay- ment initiatives, including those on cardiac care, before they launched. Mr. Azar said the agency is re-examining the models that were rolled back and is exploring new models. "We intend to revisit some of the episodic cardiac models that we pulled back and are actively exploring new and improved episode-based models in other ar- eas, including radiation oncology," Mr. Azar said. 4. In a prepared statement issued aer Mr. Azar's speech, American Society for Radiation Oncology CEO Laura evenot said the group is pleased that an alternative payment model for radiation oncology is in the works, but the organization is concerned about the model being mandatory from the start. "While ASTRO is enthusiastic about the prospects for a RO-APM, we have concerns about the possibility of launching a model that requires mandatory participa- tion from all radiation oncology practices at the out- set," she said. "ASTRO recognizes that mandatory and voluntary models can take many different forms, and we look forward to working with Secretary Azar and CMMI to determine the best approach for the field of radiation oncology." n Walmart will require workers to travel for spine surgery in effort to cut healthcare costs By Ayla Ellison W almart is aiming to lower healthcare spending by requiring employees to travel to certain hospitals for spine surgeries, according to The Wall Street Journal. Here are four things to know: 1. Over the past five years, Walmart has encouraged employees to undergo a variety of procedures, including spine, heart, hip and knee surgeries, at hospitals known for providing high-quality care. As an incentive, the retail giant offered to pay for the full cost of the proce- dures and travel. 2. Beginning in January, Walmart is mandating the travel for spine surgeries in an effort to lower healthcare costs and reduce unnecessary procedures. 3. Walmart has teamed up with major health systems for the mandatory program, including Rochester, Minn.-based Mayo Clinic, Danville, Pa.- based Geisinger and Houston-based Memorial Hermann Health System. 4. Walmart, which provides health benefits that cover more than 1 million people, will not require workers to travel to designated hospitals for heart surgeries and other procedures included in the voluntary program. n CMS accepts Vanderbilt's plan to correct Medicare deficiencies By Ayla Ellison C MS published a notice Nov. 21 threatening to terminate Nash- ville, Tenn.-based Vanderbilt University Medical Center's Medi- care provider agreement Dec. 9, stating the hospital was not in compliance with conditions of participation in the program. On Nov. 29, CMS said it accepted VUMC's plan of correction, and the hospital is not at risk of losing its Medicare contract. CMS sent VUMC the termination notice after the agency learned a pa- tient died at the hospital in December 2017 due to a medication error. The fatal medication error occurred because the hospital failed "to ensure nurses followed medication administration policies and pro- cedures," according to an inspection report. The hospital also failed to report the incident to the Tennessee Department of Health and to implement measures to ensure similar medication errors would not happen again, according to the inspection report. On Nov. 29, a CMS spokesperson said the agency accepted VUMC's revised plan of correction, which isn't being released at this time. The hospital is now under an ongoing review as it works to implement the steps outlined in the correction plan. "We continue to work with State Survey Agency and VUMC to take corrective steps to protect the health and welfare of patients served by the facility," the CMS spokesperson wrote in an email to Becker's Hospital Review. n

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