Hospitals generally support the proposed cancellation of the cardiac and Surgical Hip and Femur Fracture Treatment bundling program and Comprehensive Care for Joint Replacement bundling program and partial conversion of the CJR program to a voluntary model, AHA Executive Vice President Tom Nickels told the Centers for Medicare & Medicaid Services in comments submitted today. However, some hospitals have concerns, leading AHA to urge CMS to “expeditiously pursue the creation of new, voluntary advanced [alternative payment models] that would allow hospitals to not only capitalize on the work many of them already have done to prepare for such models, but also partner with clinicians to provide better, more efficient care.” Among other comments, AHA voiced support for allowing rural and low-volume hospitals to voluntarily participate in the CJR program, but urged the agency to increase the proposed low-volume threshold. In addition, if CMS finalizes its outpatient prospective payment system proposal to remove total knee replacement from the inpatient-only list, AHA strongly urged the agency to modify the CJR and Bundled Payments for Care Improvement programs to account for the change.

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