CMS finalizes rule for hip and knee bundled payments

Editor's Note

The Centers for Medicare and Medicaid Services (CMS) has finalized the rule that will require hospitals in 67 geographic areas to participate in a test of bundled payments for hip and knee replacements, Modern Healthcare reports.

Medicare's average bundled payment ranges from $16,500 to $33,000 for surgery, hospitalization, and recovery.

Originally, the program required 800 hospitals in 75 regions to participate, but in the final rule, CMS omitted eight regions that have too few total joint cases that aren’t already covered under a voluntary bundled-payment initiative.

Most organizations submitting comments on the proposed rule asked CMS to wait until January 1, 2017, to implement the program, but CMS only pushed it back 3 months to April 1, 2016. 

The CMS on Monday finalized a rule that will require hospitals in 67 geographic areas, including Los Angeles and New York City, to participate in a test of bundled payments for hip and knee replacements. The agency scaled back the initiative from its original plan which included 800 hospitals in 75 locations through the U.S.