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HEALTHCARE
NEWS
CMS Delays Major
Bundled Payment
Initiatives:
6 Things to Know
By Ayla Ellison
C
MS issued an interim final rule that delays im-
plementation of cardiac care bundled payment
initiatives and expansion of the existing Com-
prehensive Care for Joint Replacement model.
Here are six things to know about the interim final rule,
which was published in the Federal Register.
1. e interim final rule delays the effective date for
mandatory bundled payment programs for heart at-
tacks and bypass surgeries from July 1, 2017, until Oct.
1, 2017. Under the cardiac bundles, acute care hospitals
in certain markets will be accountable for the cost and
quality of care provided to heart attack and coronary
bypass patients beginning with hospitalization and ex-
tending 90 days aer discharge.
2. Under the rule, the cardiac rehabilitation payment
model, which will test whether a payment incentive can
increase the utilization of cardiac rehabilitative services,
is delayed from July 1, 2017, until Oct. 1, 2017.
3. e CJR model was slated to expand to include ad-
ditional surgical treatments for hip and femur fractures
beginning July 1. at expansion is delayed until Oct. 1
under the interim final rule.
4. e interim final rule further delays certain technical
changes to the CJR model, such as the requirement that
physicians and physician group practice collaborators
give written notice to Medicare beneficiaries describing
their participation in the bundled payment program.
Last month, CMS delayed implementation of these
changes from Feb. 18 to March 21. Now the agency has
delayed implementation until May 20.
5. "e additional three-month delay is necessary to al-
low time for additional review, to ensure that the agency
has adequate time to undertake notice and comment
rulemaking to modify the policy if modifications are
warranted, and to ensure that in such a case participants
have a clear understanding of the governing rules and
are not required to take needless compliance steps due
to the rule taking effect for a short duration before any
potential modifications are effectuated," according to
the interim final rule.
6. CMS is seeking comment on possibly further delay-
ing the implementation of the cardiac bundles and ex-
pansion of the CJR model. e agency said it believes a
delay until Jan. 1, 2018 is warranted. n
CHI Lays Off 459 Employees in Texas
By Ayla Ellison
E
nglewood, Colo.-based Catholic Health Initiatives' Texas di-
vision has laid off 459 employees and will leave 161 vacant
positions unfilled, according to the Houston Business Journal.
The 620 eliminated positions represent less than 4 percent of CHI's
workforce in Texas. CHI Texas Division includes CHI St. Luke's Health
in Houston, CHI St. Luke's Health Memorial in Lufkin and CHI St. Jo-
seph Health in Bryan. According to the Houston Business Journal,
CHI St. Luke's Health Memorial was not affected by the cutbacks.
Including the newest round of cuts, CHI Texas Division has eliminated
1,285 positions over the past eight months, according to the report.
"While never an easy process, rebalancing our workforce allows us
to more effectively manage our resources so that we are well posi-
tioned to serve the community into the future," CHI Texas said in a
statement to the Houston Business Journal.
CHI is focused on performance improvement and expense reduction
as part of a financial turnaround plan. The nonprofit 103-hospital sys-
tem ended the second quarter of fiscal year 2017 with an operating
loss of $153.9 million, compared to an operating loss of $112.1 mil-
lion in the same period of the year prior. CHI said operating results
declined in the second quarter of FY 2017 across several of its re-
gions, including Texas.
CHI didn't immediately respond to Becker's request for comment. n
How These 3 Trends Will Impact
ASCs Moving Forward
By Mary Rechtoris
V
ertess, a healthcare-focused merger and acquisition firm, pre-
dicts three healthcare trends that will change the ASC industry.
1. One-stop shopping. Healthcare's consumer-driven nature
is driving demand for one-stop shopping. Consumers want on-
demand services, posing opportunities for ASCs as well as urgent
care clinics and retail clinics. As this trend continues to take shape,
Vertess expects ASCs to combine with ambulatory groups, imaging
centers and other specialty groups.
2. Government reform. Officials are changing legislation that
impacts how physicians receive reimbursement. To thrive in the
competitive healthcare market, surgery centers must work on payer
negotiation strategies to obtain better contracts. Bundled payments
and shared savings may be considerations for ASCs in the pay-for-
performance future.
3. Cost reduction. Surgery centers struggle with payment as the
government pays hospital outpatient departments more for the
same procedure. To manage costs, surgery centers should monitor
their supply expenses and measure their staffing levels to patient
volume. n
