Bundled Payments & APMs
Expert articles and analysis related to bundled payments & apms.
AI Summary — Last 30 Days
Over the last 30 days, CMS has advanced a major structural shift toward mandatory bundled payment models under the Trump administration, most notably by proposing the CJR-X model—a nationwide, mandatory episode-based payment program for lower joint replacements that makes hospitals financially responsible for comprehensive care spanning surgery through recovery, emphasizing hospital coordination with home health and skilled nursing partners (details here, background here). This marks a return to mandatory bundled arrangements at national scale, with implications for hospital financial risk, downstream provider partnerships, and care redesign—signaling CMS’s intent to accelerate value-based reimbursement adoption and prompting immediate readiness planning among VBC stakeholders.
Related Articles
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. ...
Oncology Care Model Sees Net Losses Despite Spending Reductions
Oncology Care Model Sees Net Losses Despite Spending Reductions  National Today
Oncology Care Model’s Net Losses Well Exceed Savings
Oncology Care Model’s Net Losses Well Exceed Savings  Medscape
Rethinking Medicare’s Bundled Payment Model For Opioid Treatment Programs
Rethinking Medicare’s Bundled Payment Model For Opioid Treatment Programs  Health Affairs
bundled payment models
From newsletter: The TEAM Bundle Part 1: Where Hospitals Will Win and Lose Under Medicare’s Biggest Surgical Payment Overhaul The TEAM Bundle Part 1: Where Hospitals Will Win and Lose Under Medicare’s...
Bundled Payments Are Back – And This Time, Hospitals May Not Be Ready
For several years, bundled payment models appeared to be receding into the background, overshadowed by the rapid expansion of Medicare Advantage and Medicaid supplemental payment programs. That is now...
CMS proposes hospital pay bump, revived joint replacement model
CMS proposes hospital pay bump, revived joint replacement model  Modern Healthcare