Another Round of Voluntary Bundling Likely on the Way

Last week, policymakers in DC sent another strong message that value-based payment is here to stay. On the surface, Medicare’s announcement of an additional three-month delay in the implementation of mandatory bundles for hip fractures and cardiac episodes sounds like just another delay. In fact, when you consider that they could have decided to shelve the rule altogether, it is the opposite. Providers in these mandatory bundling markets should interpret this as a strong signal by the new administration that these programs are a go.

Background on Mandatory Bundling: In March, the Centers for Medicare and Medicaid Services (CMS) announced a three-month delay in these new mandatory bundles, along with providing an additional comment period on whether the start of this next round of mandatory bundling should be delayed further. On the basis of the comments received, CMS has now decided that a further delay in the implementation date from October 1, 2017, to January 1, 2018, is warranted. Importantly, the American Hospital Association (AHA) sent a strong signal that while they are in support of this additional implementation delay to January 1, 2018, they are not in support of any further delays beyond that, as hospitals need a firm date to make preparations to execute the program.

Voluntary Bundling Coming Soon: Recently, leadership of the Center for Medicare & Medicaid Innovation (CMMI) publicly stated that it remains all systems go on alternative payment models (APMs), such as mandatory and voluntary bundling and ACOs, for many reasons, including the need for Advanced Alternative Payment Models under the new physician payment rules. CMMI also publicly reiterated its intention to create another round of voluntary bundling (to be known as Advanced BPCI), possibly to be issued in coming weeks.

Ignore these signals at your own peril.

Stay tuned for an announcement of a Health Dimensions Group webinar where we will explain what these trends mean and walk through scenarios of how providers can prepare for mandatory and voluntary bundling, SNF PPS refinement, and direct assumption of risk.

In the meantime, if you have any questions, contact us at 763.537.5700 or

Authored by: Brian Ellsworth, MA, Director, Payment Transformation, Health Dimensions Group