Episode Payment Models: A Primer For Cardiology Sunny Jhamnani, MD, an ACC Emerging Advocate

Episode Payment Models (EPMs) Acute Myocardial Infarction (AMI) Model Coronary Artery Bypass Graft (CABG) Model Cardiac Rehab (CR) Incentive Payment Model

EPM Rulings Proposed rule (August 2016) Final rule (December 2016)

What You Need to Know About EPMs Hospitals within the 98 pre-selected MSAs will be participating for a performance period of July 1, 2017, to Dec. 31, 2021 The acute-care hospitals are financially responsible for episodes Cardiovascular physicians and professionals will be paid for services based on current Part B rates

What You Need to Know About EPMs Hospitals that achieve both an acceptable or better quality composite score as well as spend below the quality adjusted target price will be eligible to receive a reconciliation payment AMI and CABG EPMs will allow clinicians to be able to qualify for Advanced Alternative Payment Models under MACRA

What You Need to Know About EPMs Hospitals will receive an additional $25 for each CR or Intensive CR service for the first 11 services paid by Medicare, which will increase to $175 for each CR service after the 11th