CMS pitches bundled payment approach for hip, knee replacements

CMS has proposed requiring hospitals to be held accountable for the quality of care they deliver to Medicare beneficiaries for hip and knee replacements from surgery through recovery.

Through the proposed five-year Comprehensive Care for Joint Replacement payment model, hospitals would continue to be paid under existing Medicare payment systems. However, the hospital where the hip or knee replacement takes place would be held accountable for the quality and costs of care from the time of surgery through 90 days after discharge.

Under the payment model, hospitals would be eligible to receive an additional payment or be required to repay Medicare for a portion of the episode costs depending on the quality of care the hospital provides and its cost performance.

"These bundled payments for joint replacement surgeries would build upon successful demonstration programs already underway in Medicare," said CMS in a statement.

"By focusing on episodes of care, rather than a piecemeal system, hospitals and physicians have an incentive to work together to deliver more effective and efficient care," said HHS Secretary Sylvia Mathews Burwell. "This model will incentivize providing patients with the right care the first time and finding better ways to help them recover successfully."

The public has until Sept. 8, to comment on the proposal.

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