Who’s in? Who’s out? Medicare’s geographically-based bundled payment models.

On December 20, 2016, CMS released the Advancing Care Coordination through Episode Payment Models (Cardiac and Orthopedic Bundled Payment Models) Final Rule (CMS-5519-F).

The rule includes four new alternative payment models (APMs):

  • Acute Myocardial Infarction (AMI) Model;
  • Coronary Artery Bypass Graft (CABG) Model;
  • Surgical Hip and Femur Fracture Treatment (SHFFT) Model; and
  • Cardiac Rehabilitation (CR) Incentive Payment Model.

Each model is based on Metropolitan Statistical Areas (MSAs). If the models continue, all eligible hospitals in each MSA will be participating in the new model(s) beginning July 1, 2017. Some MSAs are included in more than one model.

Check out which MSAs are in and out here.