Rep. Price Introduces HIP Act to Delay CJR
For Immediate Release
March 24, 2016
Rosemont, Ill. — Yesterday, US Representative Tom Price, MD (R-GA) introduced the Healthy Inpatient Procedures Act of 2016 (HIP Act) that aims to suspend operation of the Centers for Medicare and Medicaid Services (CMS) Comprehensive Care for Joint Replacement (CJR) payment model until at least January 1, 2018. The CJR establishes episode-based Medicare payment for total joint replacement procedures and is scheduled to commence on April 1, 2016. Participation in the CJR is mandatory for hospitals and physicians in 67 metropolitan statistical areas around the country.
The American Association of Hip and Knee Surgeons (AAHKS) is committed to continued progress towards value-based payment as a means to improve the quality and efficiency of patient care. AAHKS offered extensive comments to CMS on the rulemaking period of the CJR. AAHKS has also met directly with CMS staff to explain how the payment model could be improved. Nevertheless, the CJR continues to include several problematic design features including:
- An insufficiently defined role for orthopaedic surgeons in coordinating the episode of care
- A blend of provider-based and regional-based pricing that may promote preference for the healthiest patients
- An ICD-10 anomaly that miscodes knee revisions as primary arthroplasty, which will lead to artificially inflated hospital reported expenditures under the CJR
- A lack of adequate risk adjustment or risk stratification in the CJR that will financially penalize the hospitals and providers who treat the sickest patients
AAHKS commends Representative Price for highlighting these issues through introduction of the HIP Act. Congressman Price is a long-time advocate for orthopaedic surgeons and their patients. We encourage other members of Congress and the Congressional Committees of Jurisdiction to focus on further improving patient outcomes and efficient use of resources for total joint replacement patients under payment models that are informed by the real-life perspective of practicing orthopaedic surgeons. AAHKS looks forward to continued work towards these goals with Congress and CMS.
About the American Association of Hip and Knee Surgeons
Established in 1991, the mission of AAHKS is to advance hip and knee patient care through education and advocacy. AAHKS has a membership of over 3,700 surgeons.
Denise Smith Rodd