Bundled Payments & Capitation
Expert articles and analysis related to bundled payments & capitation.
AI Summary — Last 24 Hours
CMS today proposed a sweeping nationwide expansion of the Comprehensive Care for Joint Replacement (CJR) model—now branded as CJR-X—which would make bundled payments for knee, hip, and ankle replacements mandatory for most hospitals starting October 1, 2027. This move under the Trump administration directly impacts value-based care (VBC) stakeholders by holding hospitals accountable for total Medicare spending across the full episode of care, intensifying the need for tight coordination across hospital, home health, and skilled nursing settings as required by the proposed policy. The CJR-X mandatory bundles are included in the Medicare FY27 inpatient rule, signaling a clear federal push toward broader episode-based and capitation payment models nationwide [HFMA coverage | details at Becker’s ASC].
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. ...