CMS proposes to bundle payments for hip and knee replacements

The Centers for Medicare & Medicaid Services today proposed a new payment model that would bundle payment to acute care hospitals for hip and knee replacement surgery. Under the proposed five-year Comprehensive Care for Joint Replacement model, the hospital in which the joint replacement takes place would be held accountable for the quality and costs of care for the entire episode of care from the time of the surgery through 90 days after discharge. According to a CMS factsheet, the hospital would “either earn a financial reward or be required to repay Medicare for a portion of the costs” based on its performance on cost and quality for the episode. The model would be in 75 geographic areas across the country and “most hospitals in those regions would be required [to] participate,” according to CMS. Comments are due to CMS Sept. 8. AHA staff are reviewing the proposed rule.