CMS proposes major initiative for total joints

Editor's Note

The Centers for Medicare & Medicaid Services is planning to require more than 800 hospitals in 75 geographic areas to participate in a bundled payments initiative for hip and knee replacements.

These procedures are among the most common that Medicare beneficiaries receive, and prices vary significantly across geographic areas—ranging from $16,500 to $33,000.

The Comprehensive Care for Joint Replacement payment program would hold hospitals accountable for the quality of care of Medicare fee-for-service beneficiaries from admission until 90 days after discharge.

Hospitals would continue to be paid for their services under existing Medicare payment systems. However, depending on the hospital’s quality and cost performance, the hospital may receive an additional payment or be required to repay Medicare for a portion of the costs. The program would begin January 1, 2016, and run for 5 years. Comments on the proposed initiative will be received until September 8, 2015.

FOR IMMEDIATE RELEASE July 9, 2015 Model supports quality and care improvements for patient's transition from surgery to recovery Hip and knee replacements are some of the most common surgeries that Medicare beneficiaries receive. In 2013, there were more than 400,000 inpatient primary procedures, costing Medicare more than $7 billion for hospitalization alone.