Hospitals participating in the first year of Medicare’s Comprehensive Care for Joint Replacement Model reduced payments for lower extremity joint replacement episodes by an average 3.3 percent more than hospitals that did not participate in the model, largely by shifting patients to less intensive post-acute care settings, according to an analysis prepared for the Centers for Medicare & Medicaid Services by the Lewin Group. For example, the share of CJR patients discharged to an inpatient rehabilitation facility fell by a relative 2.2 percentage points while the share discharged to a home health agency rose by 3.9 percentage points. The study found no changes in quality of care as measured by readmission rates, emergency department visits and mortality. CMS implemented the five-year payment model, which qualifies as an advanced alternative payment model under the Quality Payment Program for clinicians, in certain geographic areas in April 2016. The first-year report does not include estimates of the change in Medicare program savings, which were not yet available. 
 

Related News Articles

Headline
The Centers for Medicare & Medicaid Services has issued the 2025-2026 Medicaid Managed Care Rate Development Guide for states to use when setting managed…
Headline
The AHA today filed an amicus brief in the U.S. Court of Appeals for the D.C. Circuit, defending the Department of Health and Human Services’ decision to…
Headline
The Centers for Medicare & Medicaid Services Aug. 1 issued a final rule for the inpatient psychiatric facility prospective payment system for fiscal year…
Chairperson's File
Public
The recently enacted One Big Beautiful Bill Act will bring big changes to health care. AHA President and CEO Rick Pollack joined me for a Leadership Dialogue…
Headline
The AHA today expressed support for the Medicare Mental Health Inpatient Equity Act, a bill that would eliminate the 190-day lifetime limit on inpatient…
Headline
The Centers for Medicare & Medicaid Services July 14 released its calendar year 2026 proposed rule for the physician fee schedule. As required by…