Bundled Payments & Alternative Payment Models
Expert articles and analysis related to bundled payments & alternative payment models.
AI Summary — Last 30 Days
CMS, under the Trump administration, has proposed the nationwide, mandatory rollout of the Comprehensive Care for Joint Replacement model (“CJR-X”), representing a significant structural pivot toward compulsory bundled payments for joint replacement episodes starting in October 2027. This expansion would hold most hospitals financially accountable for the full scope of Medicare spending tied to joint, hip, and ankle replacements—including surgery, post-surgical care, skilled nursing, and home health—intensifying the need for hospital-led care redesign and tighter cross-continuum coordination, especially with home health agencies and skilled nursing facilities. These moves signal a renewed federal commitment to scaling episode-based payment reform and a possible blueprint for aggressive future transitions to downside risk models beyond orthopedics, with implications for ACOs and provider organizations engaged in value-based care. For details, see CMS Proposes Resurrection and Nationwide Expansion of Mandatory Joint Replacement Bundled Payment Model (CJR-X) and CMS proposes mandatory hospital-bundled model for joint replacements.
Related Articles
CMS Proposes Resurrection and Nationwide Expansion of Mandatory Joint Replacement Bundled Payment Model (CJR-X)
What Medicare’s joint replacement model expansion means for providers
What Medicare’s joint replacement model expansion means for providers  Modern Healthcare
Powering Value-Based Care with Clinician-Led, Patient-Centered Design: The MyHealth Bundles Program
Powering Value-Based Care with Clinician-Led, Patient-Centered Design: The MyHealth Bundles Program  NEJM Catalyst Innovations in Care Delivery
christian@revelaihealth.com
From newsletter: The Operator's Guide to CJR-X, the CMS Nationwide Mandatory Joint Replacement Bundle The Operator's Guide to CJR-X, the CMS Nationwide Mandatory Joint Replacement Bundle What the pr...
CMS proposes pushing Comprehensive Care for Joint Replacement Model nationwide
CMS proposes pushing Comprehensive Care for Joint Replacement Model nationwide  McKnights Home Care
CMS’ Proposed New CJR Model Aims to Drive Hospital, Skilled Nursing Coordination Nationwide
CMS’ Proposed New CJR Model Aims to Drive Hospital, Skilled Nursing Coordination Nationwide  Skilled Nursing News
CMS Proposes Expanded CJR Model, Calls For Hospital-Home Health Coordination
CMS FY27 rule expands bundled payments, adjusts Medicare inpatient reimbursement rate
For the first time, a value-based payment model is set to become mandatory for almost all hospitals nationwide. The expansion of the Comprehensive Care for Joint Replacement (CJR) bundled payment mode...
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. ...
Under Global Budgets, Hospital Utilization In Maryland Decreased By 11 Percentage Points More Than In Other States, 2013–23
Under Global Budgets, Hospital Utilization In Maryland Decreased By 11 Percentage Points More Than In Other States, 2013–23  Health Affairs