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Federal health regulators Monday proposed to test a new way to pay hospitals that treat Medicare beneficiaries for heart attacks and bypass surgery, as well as hip fractures, with an eye toward controlling costs and improving patient outcomes. Under the model proposed for a five-year demonstration project to begin next summer, which would be mandatory, hospitals would be paid on a "bundled" basis for treating such patients.

That would effectively give the hospitals a lump-sum payment from Medicare for the care, meaning that if the care ended up costing more than the bundled payment, the hospital would eat the cost. On the other hand, if the hospital kept the costs lower than what it was being paid by Medicare, it would be able to bank the savings. Also Monday, the U.S. Health and Human Services Department said it was proposing a new model to increase the number of people who undergo cardiac rehabilitation, which would encourage hospitals to steer patients to rehab. Only 15 percent of heart attack patients now undergo cardiac rehab, despite research that has found it lowers the risk of another heart attack or death. HHS also said it was proposing a way in which doctors who participate in bundled payment models would qualify for incentive payments if they met certain thresholds. The new proposed bundled payment model is the latest effort by HHS to push the health-care system toward medical providers being paid fees for overall health outcomes, as opposed to the current predominant system whether providers are paid separately for every procedure or test they perform. HHS has a goal of having 50 percent of traditional Medicare payments flow through alternative payment models by 2018; the rate currently is 30 percent.