HHS Finalizes New Medicare Alternative Payment Models

January 6, 2017
Health Policy

On December 20, the U.S. Department of Health and Human Services (HHS) finalized new Medicare alternative payment models that continue the Administration’s progress in reforming how the health care system pays for care. This announcement finalizes new policies that:

  • Improve cardiac care: Three new payment models will support clinicians in providing care to patients who receive treatment for heart attacks, heart surgery to bypass blocked coronary arteries, or cardiac rehabilitation.
  • Further improve orthopedic care: One new payment model will support clinicians in providing care to patients who receive surgery after a hip fracture beyond hip replacement. In addition, HHS is finalizing updates to the Comprehensive Care for Joint Replacement Model, which began in April 2016.
  • Provides an Accountable Care Organization opportunity for small practices: In order to encourage more practices, especially small practices, to advance to performance-based risk, the new Medicare Accountable Care Organization (ACO) Track 1+ Model will have more limited downside risk than in Tracks 2 or 3 of the Medicare Shared Savings Program.