Advocacy News

April 12, 2016

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AAOS Changes CMS Position on Shoulder Coding Issue

CJR Payment Model Starts

Bonefied News

Senate Committee Concludes Medical Innovation Work

GME Legislation Introduced in House

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2015 EHR “Meaningful Use” Hardship Exemption Information

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CJR Payment Model Starts 

The Comprehensive Care for Joint Replacement (CJR) model – a bundled payment program mandated by the Centers for Medicare and Medicaid Services (CMS) – officially kicked in on April 1, 2016. The model affects hospitals in 67 geographical areas and targets the most common inpatient surgeries for Medicare beneficiaries: hip and knee replacements, both elective and non-elective, as well as other lower extremity joint replacement procedures and the repair of hip fractures.



“The CJR model offers a chance for hospitals, doctors, and other providers to partner with CMS in furthering our shared goal of improving the quality of care for beneficiaries undergoing the most common inpatient surgery, lower extremity joint replacements,” stated Patrick Conway, CMS Principal Deputy Administrator and Chief Medical Officer in a blog post. “The model is part of the Administration’s broader strategy to improve the health care system by paying providers for what works, unlocking health care data, and finding new ways to coordinate and integrate care to improve quality.”

     
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AAOS continues to monitor CJR implementation and urge Congress and CMS to allow for a delay of the program. H.R. 4848, the Healthy Inpatient Procedures (HIP) Act, was introduced by Rep. Tom Price, MD (R-GA) and Rep. David Scott (D-GA) last month and would delay CJR implementation until January 1, 2018, ensuring that physicians, hospitals, and post-acute care providers have adequate time to prepare for the onset of this complex payment system. Read more about the legislation in Advocacy Now here.

“AAOS commends Chairman Price and Congressman Scott on the introduction of H.R. 4848,” stated Gerald R. Williams, Jr., MD, President of AAOS. “The CJR model mandated by CMS requires comprehensive planning and coordination between hospitals, physicians, and post-acute care providers, as well as complete infrastructural support. While AAOS embraces initiatives that improve quality and lower cost, it is important that all stakeholders have adequate time to prepare for this kind of substantial change to our health care delivery system in order to avoid any disruption to normal patient access and care patterns.”

Read more about CJR and other Medicare payment changes on the AAOS website at http://www.aaos.org/advocacy/medicarepaymentCMS/.