CMS has proposed expanding its Comprehensive Care for Joint Replacement model nationwide through the fiscal year 2027 hospital inpatient and long-term care payment rule.
The proposed CJR-X model would hold hospitals accountable for Medicare spending tied to joint replacement procedures and the 90 days following surgery, including post-acute care. The model is designed to improve care coordination and reduce unnecessary services such as avoidable rehospitalizations and emergency visits, according to an April 10 news release.
CMS tested the original model from April 2016 through December 2024, generating Medicare savings while maintaining care quality. If finalized, the expanded model would begin Oct. 1, 2027, and apply to most hospitals, making it the first mandatory, nationwide, episode-based payment model.
The proposed rule also includes a 2.4% payment rate increase for inpatient and long-term care hospitals in fiscal year 2027, according to the release.
At the Becker’s 32nd Annual Meeting: The Business and Operations of ASCs, taking place October 29-31 in Chicago, ASC leaders, surgeons and healthcare executives will explore strategies to drive growth, enhance operational performance, navigate reimbursement challenges and prepare for the future of ambulatory surgery. Apply for complimentary registration now.
