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On January 1st, 2018, Medicare will start a five year pilot of alternative payment models to manage patients with AMI and PCI in certain Metropolitan Selected Areas. As per the announcement, selected hospitals will receive a bundled payment for managing patients with AMI and CABG, beginning with a hospitalization and extending for 90 days following hospital discharge. A subset of hospitals will also receive an incentive payment to selected hospitals to increase the utilization of cardiac rehab for AMI and CABG patients. Incentive payments will be paid retrospectively at the rate of $25/session for the first 11 sessions and $175/session for every additional session after. Hospitals may use these payments to provide additional services that make it easier for patients to attend cardiac rehab.

Participating hospitals in the new payment models will thus belong to one of the following models:

  1. In a cardiac bundle with incentive payments
  2. In a cardiac bundle with no incentive payments
  3. Not in a cardiac bundle but with Incentive payments
  4. Neither in a bundle nor in incentive payments

You can look up which model your hospital belongs to using this tool, and later learn the strategies for success in a changing reimbursement landscape, more specific implications of the cardiac bundle, the role of cardiac rehab in bundled payment models and how to leverage technology in cardiac rehab.

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Implications of the Cardiac Bundled Payment

Harsh Vathsangam, PhD – Nov 16th, 2017