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CMS Proposes Mandatory Bundled Payment for Joint Replacement

July 10, 2015

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PRESS CONTACTS
Ivy Baer, Senior Director and Regulatory Counsel

The Centers for Medicare and Medicaid Services July 9 posted a proposed rule that requires most acute care hospitals to participate in a bundled payment model for hip and knee replacements. The Comprehensive Care for Joint Replacement (CJR) payment model, would begin Jan. 1, 2016, and run for five years. CMS is accepting comments through Sept. 8.

Under the proposed rule, hospitals would be accountable for costs and quality of care. The episode would include the procedure, inpatient stay, and all related care covered under Medicare Parts A and B within 90 days after discharge, including hospital care, post-acute care, and physician service. According to CMS, hospitals would earn either a financial reward or be required to repay Medicare for a portion of the costs.

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