The U.S. Department of Health and Human Services (HHS) announced that the effective date for the final rule for Advancing Care Coordination Through Episode Payment Models (EPMs); Cardiac Rehabilitation (CR) Incentive Payment Model; and Changes to the Comprehensive Care for Joint Replacement Model has been further delayed until May 20, 2017. This postpones the start date of the EPMs and the CR Incentive Payment Model for three months – from July 1, 2017 to Oct. 1, 2017. In its statement, HHS noted it is seeking comments on the appropriateness of this delay, as well as a further start date delay until Jan. 1, 2018.

According to HHS, the additional three–month delay "is necessary to allow time for additional review" and to ensure that the agency "has adequate time to undertake notice and comment rulemaking to modify the policy if modifications are warranted, and to ensure that in such a case participants have a clear understanding of the governing rules and are not required to take needless compliance steps due to the rule taking effect for a short duration before any potential modifications are effectuated."

"Creating value–based payment models for patients with cardiovascular disease is extremely challenging and the ACC has urged the Centers for Medicaid and Medicare Services (CMS) to proceed with great caution in implementing and testing these models in order to ensure that they allow for accurate beneficiary attribution, valid quality and cost measurement, meaningful comparisons, and ultimately development of best practices to achieve better health outcomes for patients," says ACC President Mary Norine Walsh, MD, FACC. "This newest delay provides an opportunity to continue working with CMS to find ways to further refine and improve the effectiveness of the models' clinical and operational designs. The ACC's NCDR registries may be helpful in this effort. In the meantime, the College encourages members who are part of the model to continue to prepare for implementation."