American Association of Hip and Knee Surgeons

Advocacy, Education, Research

CMS Proposed Rule for Hip and Knee Replacement Payment Model

The Centers for Medicare and Medicaid Services (CMS) proposed an extensive “pilot” of a new Medicare Part A and B payment model, “Comprehensive Care for Joint Replacement (CCJR) Model” under which acute care hospitals in geographic areas covering about 25% of patients will receive retrospective bundled payments for episodes of care for hip and knee replacement surgery. The mandatory initiative, designed by the Center for Medicare and Medicaid Innovation (CMMI), will test “whether bundled payments to acute care hospitals for lower extremity joint replacement episodes of care will reduce Medicare expenditures while preserving or enhancing the quality of care for Medicare beneficiaries.”

CMS is proposing to test the new CCJR model for a 5 year performance period, beginning January 1, 2016, and ending December 31, 2020. Comments must be received by September 8, 2015.

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