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Bundled Payments (BPCI/CJR)

Expert articles and analysis related to bundled payments (bpci/cjr).

22 articles•Last 30 Days

AI Summary — Last 30 Days

In the past 30 days, CMS under the Trump administration has proposed a mandatory, nationwide expansion of the Comprehensive Care for Joint Replacement model (CJR-X), requiring most hospitals to manage entire episode costs for knee, hip, and ankle replacements across surgery and recovery, effective October 2027. This sweeping shift signals an aggressive move toward large-scale episode-based payment, intensifying the pressure on hospitals, ACOs, and post-acute providers to coordinate care and manage downside risk across care settings, particularly involving home health and skilled nursing partners [CMS proposes mandatory hospital-bundled model for joint replacements, CMS proposes expanded CJR model, calls for hospital-home health coordination]. With anticipated episode payment discounts and increased financial accountability on providers, the new policy accelerates value-based care transformation and care delivery redesign while raising stakes for those unprepared to manage clinical and cost variation at scale.

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