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Bundled Payments

Expert articles and analysis related to bundled payments.

7 articles•Last 7 Days

AI Summary — Last 7 Days

CMS is moving bundled payments back toward mandatory, episode-based accountability in musculoskeletal care, with CJR-X positioned as an expansion/refresh of the Comprehensive Care for Joint Replacement model and stakeholders framing it alongside TEAM, ACCESS, LEAD, ASM, and RISE as a broader Medicare push to reshape orthopedic episodes around cost, quality, site-of-care, and post-acute utilization. The key VBC tension is operational: hospitals, ASCs, surgeons, SNFs, and conveners are being pushed to manage total-joint episodes more tightly, while concerns persist around SNF access, inpatient-vs-outpatient status, and whether mandatory bundles will create savings without constraining appropriate rehab after surgery. See AAPC on CMS’s joint replacement expansion and RAC Monitor on SNF rehab access and CJR’s return.

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From newsletter: Follow the Incentives: How CMS is Reshaping Musculoskeletal Care, One Model at a Time Follow the Incentives: How CMS is Reshaping Musculoskeletal Care, One Model at a Time TEAM, ACC...

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CMS Auditor Threatens Patient Access to SNF Rehab After Surgery, and CJR Returning

I am having a disagreement with the Centers for Medicare & Medicaid Services (CMS) that is worth discussing. As I have been teaching for the last 10 years, when CMS took total knee arthroplasty off th...

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The opportunities in CMS’ proposed total joint model

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