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AHA comments on proposed bundled payment performance measure

January 29, 2013

The AHA today recommended changes to a proposed Medicare performance measure that assesses payments to hospitals, physicians and post-acute providers during a 30-day episode of heart attack care, and outlined how the measure should be applied to public reporting programs. In a letter to the Centers for Medicare & Medicaid Services, AHA said the proposed measure should exclude patients with unique clinical needs who are likely to incur disproportionately different costs, as well as transfer patients. In addition, the risk adjustment model should account for dually eligible Medicare and Medicaid patients and potential complications not caused by hospital care, AHA said. When applying the measure to public reporting programs, CMS should assign accountability only to organizations with the appropriate structure and processes to manage bundled payments; pilot test the measure with organizations actively engaged in bundled payment programs; and ensure the measure uses an adequate minimum sample size, AHA said.