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April 4, 2017



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CMS Delays Implementation of Bundled Payment Model

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CMS Delays Implementation of Bundled Payment Model

On March 21, 2017, the Centers for Medicare & Medicaid Services (CMS) published an interim final rule with comments that delays the Surgical Hip and Femur Fracture Treatment (SHFFT) model from the original implementation date of July 1, 2017 to October 1, 2017. Additionally, CMS is asking for comments to further delay the start date to January 1, 2018. In addition, the rule means that compliance requirements for the Comprehensive Care for Joint Replacement (CJR) model related to becoming an Advanced Alternative Payment Model (APM) will not begin until October 1, 2017.

CMS has announced this delay to allow time for additional review and if needed, start notice and comment rulemaking to modify the policy. Most importantly, the American Association of Orthopaedic Surgeons (AAOS) has expressed concerns about the mandatory nature of these payment models, the lack of reliable data, and lack of risk-adjustment associated with these programs. “While the AAOS supports the efforts of all stakeholders to develop and evaluate payment methodologies that will incentivize coordination of care among providers and help curb health care inflation, we have expressed to CMS our concern about serious unintended consequences for Medicare beneficiaries and physicians with these mandatory programs,” said then-President Gerald R. Williams, Jr., MD in a letter to CMS.

The AAOS will comment on the appropriateness of this delay and other issues of concern to our membership by the deadline of April 19, 2017 and will watch for future rulemaking in this context. Read the interim final rule here: and email any concerns or questions to