HFMA Advancing Care Coordination Through Episode Payment Models (EPMs) Proposed Rule Summary

CMS proposes to make modifications to the CJR model, create three EPMs for care of AMI, CABG, and SHFFT, and create the CR model using its authority under section 1115A. The proposed Cardiac Rehabilitation (CR) Incentive Program is also briefly described, under which additional payments for CR and intensive cardiac rehabilitation (ICR) services would be made during the follow-up care of AMI and CABG patients.The proposed rule also expands opportunities for Advanced Alternative Payment Model (APM) participation by eligible professionals (through Track 1 in each of the new EPMs and in the modified CJR), potentially allowing them to achieve Qualifying Participant (QP) status and APM-related payment incentives.