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Bundled Payment Models

Expert articles and analysis related to bundled payment models.

29 articles•Last 30 Days

AI Summary — Last 30 Days

In the past 30 days, CMS under the Trump administration has proposed the nationwide, mandatory Comprehensive Care for Joint Replacement expansion (CJR-X), marking a significant structural shift back toward mandatory episode-based payment models and heightened accountability for hospitals across all Medicare regions. The CJR-X proposal would require hospitals to manage costs and outcomes for knee, hip, and ankle replacements, with particular emphasis on post-acute coordination with home health and skilled nursing providers, starting October 1, 2027—reshaping incentives and operational realities for VBC stakeholders, ACOs, and population health entities. This move signals CMS’s renewed commitment to downside risk and advanced alternative payment models, while raising operational and financial challenges for health systems and their partners in managing bundled care at scale [CMS Proposes Resurrection and Nationwide Expansion of Mandatory Joint Replacement Bundled Payment Model (CJR-X)][CMS proposes mandatory hospital-bundled model for joint replacements].

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CMS FY27 rule expands bundled payments, adjusts Medicare inpatient reimbursement rate

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CMS proposes mandatory hospital-bundled model for joint replacements

CMS is proposing a mandatory, nationwide episode-based payment model for joint replacements that would hold most hospitals responsible for Medicare spending tied to a patient’s surgery and recovery.  ...

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