Question special

Debate on health care reform and repeal this year has mostly focused on issues of insurance coverage, such as the mandate, state exchanges, Medicaid, and essential benefits. Health policy issues on the delivery side have seen much less attention. Last week, CMS announced reductions in mandatory participation in Medicare's Comprehensive Care for Joint Replacement Model and cancellations of two other bundled payment programs (Episode Payment Models and the Cardiac Rehabilitation Incentive Payment Model) - both originally mandatory programs. What are the implications of these changes on the momentum away from fee-for-service payment systems, Medicare spending, and quality of care for patients?