CMMI's Adam Boehler: 'Now is the time' to bring post-acute care bundle ideas

WASHINGTON, D.C.—The Trump Administration is eyeing the concept of creating post-acute care bundles, the head of the Centers for Medicare & Medicaid Services' innovation arm told an audience at the American Hospital Association conference on Monday.

"Now is the time to bring us ideas there. We're really in listening mode," said Adam Boehler, director of the Center for Medicare and Medicaid Innovation (CMMI). "I think there's been a lot of intrigue and interest we've heard from people. So we're gathering stakeholder input there on that and it's a great time to give us thoughts on where we can lower costs." 

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Boehler's comments echo interest raised by the Medicare Payment Advisory Commission (MedPAC), which advises Congress on Medicare issues. Last month, the commission weighed new payment approaches in post-acute care, including episodic payments and a system built around types of stays. They ultimately concluded post-acute care may not be the optimal space—yet—for bundled payments.

In the fall, CMS Administrator Seema Verma said the Trump administration was looking at ways to expand site-neutral payments to other areas of care, including post-acute care.

Other moves on the horizon

On Monday, Boehler also told the crowd of hospital industry experts that, in the near term, they should expect to see more changes to compensation in the primary care space.

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"For those of you that have employed doc groups, I think there might be more opportunities for primary care physicians to engage in a positive way," Boehler said.

Prior to his appointment, Boehler was the CEO of Landmark Health, a medical group that focuses on integrating technology to care for chronically ill patients at home and operated largely on value. During his time at the Department of Health and Human Services (HHS) he has expressed support for alternative payment models (APMs), noting that CMMI can play a role in finding providers that are ready to take on more risk. 

Boehler also said health care groups should expect to see more work on the "kidney care side," referring to previous statements of concern about the U.S. kidney care system and its lack of home-based options. "It's an area we're working closely on with industry whether it be with dialysis centers, whether that be nephrologists and others, we've had a lot of interaction in a positive way," he said.