Weekly roundup: CMS has been busy

Among other efforts and on the heels of the release of the final privacy rule, the Centers for Medicare & Medicaid Services (CMS) has released its final rule seeking to increase public awareness of financial relationships between drug and device manufacturers and certain healthcare providers. Called the “National Physician Payment Transparency Program: Open Payments,” this is one of the steps in the Patient Protection and Affordable Care Act designed to create greater transparency in the healthcare market, according to the agency.

“You should know when your doctor has a financial relationship with the companies that manufacture or supply the medicines or medical devices you may need,” said Peter Budetti, MD, JD, CMS deputy administrator at the Center for Program Integrity. “Disclosure of these relationships allows patients to have more informed discussions with their doctors.”

The rule finalizes the provisions that require manufacturers of drugs, devices, biologicals and medical supplies covered by Medicare, Medicaid or the Children’s Health Insurance Program (CHIP) to report payments or other transfers of value they make to physicians and teaching hospitals to CMS. The agency will post the data to a public website. The final rule also requires manufacturers and group purchasing organizations (GPOs) to disclose to CMS physician ownership or investment interests. 

CMS also announced its Bundled Payments for Care Improvement initiative in which more than 500 organizations will begin participating. Through this new initiative, CMS will test how bundling payments for episodes of care can result in more coordinated care for beneficiaries and lower costs for Medicare.

“The objective of this initiative is to improve the quality of healthcare delivery for Medicare beneficiaries, while reducing program expenditures, by aligning the financial incentives of all providers,” said Acting CMS Administrator Marilyn Tavenner.

The Bundled Payments for Care Improvement initiative includes four models of bundling payments, varying by the types of healthcare providers involved and the services included in the bundle. Depending on the model type, CMS will bundle payments for services beneficiaries receive during an episode of care, encouraging hospitals, physicians, post-acute facilities and other providers as applicable to work together to improve health outcomes and lower costs. Organizations of providers participating in the initiative will agree to provide CMS a discount from expected payments for the episode of care, and then the provider partners will work together to reduce readmissions, duplicative care and complications to lower costs through improvement.

Beth Walsh, editor

bwalsh@trimedmedia.com