House act could delay CMS' CJR model until 2018 — 6 key notes

Orthopedic Sports Medicine

The Healthy Inpatient Procedures Act, which was recently introduced in the House of Representatives, aims to push implementation of CMS' Comprehensive Care for Joint Replacement payment model from April 1, 2016 to January 1, 2018.

Here are six key notes:

 

1. The HIP Act was introduced by Reps. Tom Price (R-Ga.) and David Scott (D-Ga.), and it has been referred to both the House Energy and Commerce and Ways and Means committees.

 

2. Mr. Price said the delay in implementation is warranted to give all those involved time to better assess, review and weigh the impact and consequences of this proposal as well as more adequately prepare so patients are protected.

 

3. The implementation delay would also benefit post-acute care facilities, in addition to the hospitals on the hook for the bundled payments, by giving them additional time to implement the changes required by the CJR without impacting patient care.

 

4. The CJR model's goal is to give hospitals a financial incentive to work with physicians, home health agencies, skilled nursing facilities and other providers, promoting coordinated care.

 

5. David Friend, MD, consulting managing director at The BDO Center for Healthcare Excellence and Innovation, estimates the CJR model could cause 25 percent of one-and two-star skilled nursing facilities to close over the next five years, as hospitals seek partnerships with high-quality, post-acute care facilities.

 

6. The HIP Act has earned praise from the American Academy of Orthopaedic Surgeons, which said providers could face startup and integration problems without the delay, making it more difficult to achieve improvements in quality of patient care as well as in costs.

 

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