Bundled Payments & Alternative Payment Models

Over the past week, CMS proposed a major policy shift by reviving and expanding the Comprehensive Care for Joint Replacement (CJR) model—now termed CJR-X—into a nationwide, mandatory bundled payment program for lower extremity joint replacements, with a specific emphasis on coordinated hospital, post-acute, and home health care. This move under the Trump administration signals a renewed commitment to mandatory value-based payment models, raising both operational questions for providers and strategic considerations for payers and ACOs, given the broad scope and potential integration of AI-enabled care redesign. Concurrently, HHS Secretary Robert F. Kennedy Jr.'s congressional testimony underscored anticipated adjustments in Medicare payment policy for FY27, highlighting evolving budgetary priorities and the centrality of bundled and alternative payment models in future reimbursement structures. (Hall Render, HFMA)