CMS Releases IPPS Proposed Rule with New Mandatory CJR-X Bundle

Last week, the Centers for Medicare & Medicaid (CMS) released the FY2027 Medicare Inpatient Hospital Prospective Payment System Proposed Rule. Included in the 576-page Rule are significant polices from the CMS Innovation Center (CMMI), including proposed changes to the Transforming Episode Accountability Model (TEAM) and a proposed nationwide, mandatory indefinite expansion of the CJR, to be known as “CJR-X”, beginning 2028. CMS says “The [CJR-X] presents an opportunity to further improve the quality of care for [LEJRs] furnished to Medicare beneficiaries nationwide by incentivizing hospitals, physicians, and post-acute care providers to work together to improve the quality and coordination of care from the initial hospitalization or procedure through recovery.” Even though CJR achieved some savings, cost reduction is not an explicit CMS goal for CJR-X. Click here to review the AAHKS summary of the major CJR-X parameters, comparing them to TEAM and its proposed change. AAHKS is preparing our comments to CMS, due June 9.