White Papers


The Top Ten Things You Need to Know About the Medicare Mandatory Bundled Payment Model

DATE:
August 21, 2015

In July 2015, the Centers for Medicare and Medicaid Services (CMS) proposed its Comprehensive Care for Joint Replacement (CJR) payment model, a pilot bundled payment program for the most common inpatient surgeries for Medicare beneficiaries—hip and knee replacements, known as lower extremity joint replacements (LEJRs). While CMS’ increasing interest in bundled payments has been apparent, the announcement of this mandatory initiative was a surprise to many, given that the Bundled Payments for Care Improvement (BPCI) demonstration program, initiated in 2013, is still in its early stages.  CJR would be mandatory for hospitals in 75 Metropolitan Statistical Areas (MSAs).

This white paper examines the top ten things every hospital executive should know about the proposed CJR program, its relationship to the BPCI demonstration, and the implications of this model for other innovative payment models.

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